Nuclear Chromatin Heterogeneity in High-Grade PanIN Detected by Serial Pancreatic Juice Aspiration Cytological Examination (SPACE): A Report of Two Cases.
Miyu Kato, Ruka Aoki, Aya Ohya et al.
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Case in brief
Two cases of high-grade pancreatic intraepithelial neoplasia (high-grade PanIN) were identified through serial pancreatic juice aspiration cytological examination (SPACE). Case 1 exhibited focal high-grade PanIN with mild atypia, while Case 2 presented multifocal high-grade PanIN with numerous atypical cells. Both cases demonstrated heterogeneous nuclear chromatin staining, with image analysis revealing significant differences in nuclear characteristics, indicating varying degrees of nuclear atypia.
What made this case unusual
Despite differing cytological appearances, both cases exhibited shared nuclear chromatin heterogeneity, highlighting a potential common feature in high-grade PanIN diagnosis.
Diagnostic / clinical pearl
Nuclear chromatin heterogeneity may be a key diagnostic feature in high-grade PanIN, even when cytological atypia varies significantly between cases.
Why it matters
Utilizing image analysis and hyperspectral imaging can enhance the objective evaluation of chromatin heterogeneity, potentially improving diagnostic accuracy for high-grade PanIN.