Which statement best describes the histologic hallmark of pancreatic ductal adenocarcinoma?

Which statement best describes the histologic hallmark of pancreatic ductal adenocarcinoma?

• A. Desmoplastic stroma with gland-forming malignant cells
• B. Intense neutrophilic infiltration with no glands
• C. Gland-forming malignant cells without stromal reaction
• D. Lymphoid infiltration around ducts

Answer: (C)

Pancreatic ductal adenocarcinoma is classically seen as malignant ductal (gland-forming) cells embedded in a dense desmoplastic stroma. The cancerous ducts form irregular, angulated glands that invade surrounding tissue, and the surrounding fibrous, collagen-rich stroma—desmoplasia—is a defining accompanying feature. This stromal response is produced by cancer-associated fibroblasts and pancreatic stellate cells and gives PDAC its firm texture and the characteristic microscopic appearance. So the best description is gland-forming malignant cells with a prominent desmoplastic (fibrous) stroma. Absence of stroma or a focus on neutrophilic inflammation or lymphoid around ducts would not fit PDAC’s typical histology.

Pancreatic ductal adenocarcinoma is classically seen as malignant ductal (gland-forming) cells embedded in a dense desmoplastic stroma. The cancerous ducts form irregular, angulated glands that invade surrounding tissue, and the surrounding fibrous, collagen-rich stroma—desmoplasia—is a defining accompanying feature. This stromal response is produced by cancer-associated fibroblasts and pancreatic stellate cells and gives PDAC its firm texture and the characteristic microscopic appearance. So the best description is gland-forming malignant cells with a prominent desmoplastic (fibrous) stroma. Absence of stroma or a focus on neutrophilic inflammation or lymphoid around ducts would not fit PDAC’s typical histology.