{"id":45030,"date":"2025-08-05T14:04:26","date_gmt":"2025-08-05T06:04:26","guid":{"rendered":"https:\/\/medicine.nus.edu.sg\/pathweb\/?page_id=45030"},"modified":"2025-08-05T16:44:56","modified_gmt":"2025-08-05T08:44:56","slug":"eus-fna-1","status":"publish","type":"page","link":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/cyto-mystery-cases\/eus-fna-1\/","title":{"rendered":"Mystery cases &#8211; EUS-FNA 1"},"content":{"rendered":"\n<h2>\n\t\tEUS-FNA 1\n\t<\/h2>\n\t<h1>Pancreatic mass<\/h1>\n\t<p><strong>Clinical history<\/strong>: A 65-year-old gentleman presented with painless obstructive jaundice and imaging studies revealed a 3.4 cm mass in the head of the pancreas. Endoscopic ultrasound-guided fine needle aspirate of the mass was performed.<\/p>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/06\/eus-fna-1.jpg\" alt=\"EUS-FNA 1\" itemprop=\"image\" height=\"768\" width=\"768\" title=\"eus-fna 1\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Cytologic findings<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/06\/eus-fna-2.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>The smears show two distinct cell populations:<\/p>\n<ul>\n<li>Benign pancreatic acinar cells:\n<ul>\n<li>Cohesive &#8220;grape-like&#8221; aggregates<\/li>\n<li>Polygonal-shaped acinar cells<\/li>\n<li>Nuclei: eccentric, round, evenly distributed fine granular chromatin.<\/li>\n<\/ul>\n<\/li>\n<li>Malignant cells:\n<ul>\n<li>Irregular clusters with overlapping nuclei (&#8220;drunken honeycomb&#8221;)<\/li>\n<li>Isolated single cells with marked atypia<\/li>\n<li>Moderate to marked cytologic atypia:\n<ul>\n<li>Nuclear membrane: notches, grooves, convolutions<\/li>\n<li>Nuclear size: enlarged, anisonucleosis (&gt;4:1 in one sheet)<\/li>\n<li>Chromatin clumping and nuclear clearing<\/li>\n<li>Mitoses<\/li>\n<\/ul>\n<\/li>\n<li>Cytoplasmic mucin vacuoles<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-1\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-1\">Diagnosis<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-1\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t&nbsp;<br \/>\n<strong>Adenocarcinoma<\/strong>\n\t<p><em>Case writer: Dr Noel Chia<\/em><\/p>\n\n","protected":false},"excerpt":{"rendered":"<p>EUS-FNA 1 Pancreatic mass Clinical history: A 65-year-old gentleman presented with painless obstructive jaundice and imaging studies revealed a 3.4 cm mass in the head of the pancreas. Endoscopic ultrasound-guided fine needle aspirate of the mass was performed. Cytologic findings Expand &nbsp; The smears show two distinct cell populations: Benign pancreatic acinar cells: Cohesive &#8220;grape-like&#8221; [&hellip;]<\/p>\n","protected":false},"author":828,"featured_media":0,"parent":44933,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-45030","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>NUS Pathweb<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/cyto-mystery-cases\/eus-fna-1\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:description\" content=\"EUS-FNA 1 Pancreatic mass Clinical history: A 65-year-old gentleman presented with painless obstructive jaundice and imaging studies revealed a 3.4 cm mass in the head of the pancreas. 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