High power: Pap stain
Malignant cells with enlarged irregular nuclei, coarse chromatin, and delicate cytoplasm
Medium power: Pap stain
Cohesive 3D cluster of cells with high N:C ratio, enlarged irregular nuclei and delicate cytoplasm
Features
Architecture
• 3D crowded clusters and sheets and single cells
• May have acinar formation
• Cannot differentiate cytologically from other adenocarcinomas of upper GI/ panceatic origin
Cellular features
• High N:C ratios
• Delicate vacuolated cytoplasm
• May show squamoid features with dense cytoplasm
Nuclear features
• Nuclei enlarged, irregular
• Coarse chromatin
• Prominent nucleoli
• May have multinucleation
• May show cell-in-cell formation
Background
• Bile usually present
• Necrosis often present with debris
• Mitosis may be present