Pancreatic Histology: A Case-Based Approach

This lecture offers the following credit types: CME, P.A.C.E.®, Florida
 

The presentation addresses diagnostic challenges encountered in fine needle core biopsies of pancreatic mass lesions through a case-based approach. There will be a review of key histologic features essential for distinguishing pancreatic ductal adenocarcinoma (PDAC) from benign conditions, particularly chronic pancreatitis, using both morphological and immunohistochemical techniques. The presentation explores the diagnostic differential between neuroendocrine neoplasms, acinar cell carcinomas, and solid pseudopapillary lesions in the context of mixed pancreatic tumors, highlighting a few potential immunohistochemical pitfalls. Additionally, the presentation covers rare diagnoses that may not typically be considered in the setting of pancreatic mass lesions, as well as the uncommon occurrence of metastatic lesions to the pancreas.

Originally published on March 2, 2026

Lecture Presenter

Kajsa Affolter, MD

Kajsa Affolter, MD

Associate Professor (Clinical)
University of Utah School of Medicine
Section Head, Surgical Pathology
ARUP Laboratories

Dr. Kajsa Affolter is the medical director of anatomic pathology at ARUP Laboratories and an associate professor (clinical) at the University of Utah School of Medicine. Dr. Affolter graduated from Kansas University School of Medicine with a medical degree. She completed both an anatomic and clinical pathology residency and a gastrointestinal pancreatic and hepatobiliary pathology fellowship at the University of Utah. Dr. Affolter is certified by the American Board of Pathology. She specializes in gastrointestinal, pancreatic, and hepatobiliary pathology, and her research interests include pancreatic neoplasia, inflammatory bowel disease, and gastrointestinal polyposis syndromes.

Objectives

After this presentation, participants will be able to:

  • Distinguish pancreatic ductal adenocarcinoma from benign pancreas on core needle biopsies
  • Describe how to approach possible mixed pancreatic neoplasms
  • Discuss diagnostic possibilities beyond the conventional spectrum of pancreatic masses
  • Identify which malignancies are more likely to metastasize to the pancreas

Sponsored by:

Spencer Fox Eccles School of Medicine at the University of Utah, Department of Pathology,
and ARUP Laboratories