ECP 2022 Abstract Book

Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 Cytology and biopsy diagnosis for advance inoperable disease in PDCA is highly useful, allowing anatomopathological diagnosis for chemotherapy and radiotherapy treatment decisions. Accuracy measurement of the two tests requires a larger series that include surgical specimen diagnosis as a gold standard. E-PS-07-021 First presentation of amyloidosis diagnosed in a gallbladder specimen E. Stoupi*, D. Myoteri, K. Papadopoulos, A. Vezakis, D. Tiniakos *Aretaieion University Hospital of Athens, Pathology Department, Greece Background & objectives: Amyloidosis is caused by extracellular deposition of insoluble fibrillar proteins. Two major types are AL-primary,myeloma associated and AA-secondary amyloidosis. Common sites include kidneys,heart,liver, nervous system and gastrointestinal tract. We present a rare case of gallbladder amyloidosis discovered incidentally after cholecystectomy. Methods: An 83-year-old male without significant medical his- tory presented with fever and upper right quadrant pain. Clinical findings were consistent with acute calculous cholecystitis. A chol- ecystectomy was performed. Results: Grossly, the gallbladder wall was thick (0,7 cm), focally perforated, the mucosal surface was granular and brownish and the lumen contained one gallstone. On histology, ulcerated follicular cholecystitis and pericholecystitis were observed. In addition, eosinophilic amorphous depositions were observed in the lamina propria and the wall of small blood vessels. The amorphous material was diastase-PAS(+), blue in Masson trichrome and Congo Red(+) with mild apple-green birefringence under polarized light. Immunohistochemically it was positive for serum amyloid P-SAP(+) and negative for SAA(+). Conclusion: Gallbladder amyloidosis is extremely rare, with fewer than 20 cases reported. It is suggested that ischemic damage and loss of wall contractility caused by amyloid deposition may be a significant driving factor for inflammation. If found incidentally in an otherwise healthy patient, as in our case, further examination is required to discover the underlying aetiology. In the present case, follow up information was scant but there was clinical suspicion of multiple myeloma, indicative of AL- amyloidosis. E-PS-07-022 Pancreatic cavernous haemangioma – a welcome diagnosis for a pancreatic mass G. Fontinha*, J. Gama, R. Oliveira, M.R. Silva, M.A. Cipriano *Centro Hospitalar e Universitario de Coimbra, Department of Pathology, Portugal Background & objectives: Pancreatic haemangioma is a very rare entity with fewer than 30 cases reported in the English literature. It has an unspecific clinical presentation usually being asymptomatic or presenting with abdominal pain. Methods: In this case report we present the case of a 73-year- old male with inflammatory bowel disease with complaints of left abdominal flank pain. A CT-scan was performed showing a caudal pancreatic nodule. The lesion was hypodense with central hypervascularization raising the hypothesis of a neuroendrocrine neoplasia or an adenocarcinoma. The patient underwent a distal pancreatectomy and splenectomy. Results: The gross examination showed a well circumscribed lesion with expansive growth. It was 6x4,3x3,9 cm and had a yellowish cut surface with haemorrhagic areas. Histology revealed a proliferation of dilated vascular spaces lined by typical endothe- lium with multiple thrombi and recanalization areas. The lesion was encapsulated by a fibrous bland tissue. The remaining pancre- atic parenchyma exhibited signs of chronic obstructive pancrea- titis – severe fibrosis, acinar atrophy and Wirsung duct dilation. Twenty-two peripancreatic, perisplenic and celiac lymph nodes showed no tumour cells. Conclusion: Although a rare entity in the pancreas cavernous hae- mangioma is histologically similar to haemangiomas arising in other locations. Its diagnosis may be obscured by its rarity, but it should be a part of the differential diagnosis regarding hypervascu- larizated lesions on CT-scan and entities with vascular differentia- tion microscopically as it has a very favourable prognosis. E-PS-07-023 Pancreatoblastoma: a case report A. Yavuz*, T. Kus, A. Alpsoy, Ö.C. Günizi, B. Unal, C.İ. Başsorgun, G.O. Elpek *Akdeniz University Department of Pathology, Turkey Background & objectives: Pancreatoblastoma(PB) is a rare malignancy of childhood. Although the primary treatment is surgical resection, a standardized chemotherapy/radiotherapy protocol does not yet exist. Herein presented a case of PB who underwent surgical resection to emphasize clinicopathological features in these rare tumours. Methods: Pathological examination was performed by routine hematoxylin-eosin and immunohistochemical staining. Results: In a 6-year-old boy, post-traumatic abdominal imaging incidentally revealed a solid lesion in the body and tail of the pancreas. In addition, metastatic masses were detected in the retroperitoneum. Histopathological examination revealed a tumour tissue consisting of epithelial cells forming solid areas admixed with squamous epithelial cell islands consistent with PB. The patient was treated with neoadjuvant chemotherapy (Carboplatin and Doxorubicin). In the resected specimen following regression of the tumour, solid epithelial areas observed in the pretreatment tumour biopsy were predominantly replaced by epithelial cells forming gland-like structures, and the number of squamous epithelial cell islands decreased. The patient did not experience any recurrence or metastasis (24 months). Conclusion: The case presented here supports the findings that PB can be observed incidentally in young males on a non-syn- dromic basis. Although further cases are required to conclude, it also emphasizes the beneficial effect of neoadjuvant therapy in PB treatment. E-PS-07-024 Cholangiocarcinoma: fusions in FGFR2 detected in liquid biopsy M.E. Patriarca*, M.I. Coma, D. Naranjo Hans, M.C. Fernández Rodríguez, B. Bellosillo, L. Visa Turmo, B. Lloveras *Pathology Department, Hospital del Mar-Parc de Salut Mar, Bar- celona, Spain Background & objectives: Cholangiocarcinoma constitutes a hetero- geneous group of malignant tumours originating in the biliary tree. The absence of an early diagnosis, intra-intertumoral variability, and chemoresistance, lead to a disappointing prognosis. Methods: We present a 59-year-old male patient with a history of chronic hepatitis B with undetectable viral load. In 2017, a previ- ously unknown lesion in segment VIII was diagnosed by imaging S245