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Pathology · USMLE Step 1

USMLE Pathology: Pancreatic and Biliary Tumors

Pancreatic adenocarcinoma and biliary tract tumor morphology and classic presenting features, one finding per card.

30 cards · basic cards · AI-written, checked twice. Edit anything.

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Where in the pancreas do most pancreatic adenocarcinomas arise?
The head of the pancreas.
What precursor lesion gives rise to pancreatic ductal adenocarcinoma?
Pancreatic intraepithelial neoplasia (PanIN).
What is the most common histologic subtype of pancreatic cancer?
Ductal adenocarcinoma.
Why does a tumor in the head of the pancreas classically cause painless jaundice?
It compresses and obstructs the common bile duct.
What is Courvoisier sign?
A palpable, nontender, distended gallbladder in a jaundiced patient, suggesting malignant biliary obstruction.
What is Trousseau sign (syndrome) in the context of malignancy?
Migratory superficial thrombophlebitis, a paraneoplastic finding classically linked to pancreatic adenocarcinoma.
Which oncogene is mutated in the vast majority of pancreatic ductal adenocarcinomas?
KRAS.
Which tumor suppressor gene, involved in TGF-beta signaling, is commonly inactivated in pancreatic ductal adenocarcinoma?
SMAD4 (DPC4).
Which serum tumor marker is used to monitor pancreatic adenocarcinoma?
CA 19-9.
What is the leading modifiable risk factor for pancreatic adenocarcinoma?
Cigarette smoking.
What chronic pancreatic condition raises the risk of pancreatic adenocarcinoma?
Chronic pancreatitis.
What is the typical prognosis of pancreatic ductal adenocarcinoma?
Poor, since most patients present at an advanced or unresectable stage.
Why do tumors in the body or tail of the pancreas often present later than head tumors?
They do not obstruct the bile duct, so there is no early jaundice.
What stromal reaction characteristically surrounds pancreatic ductal adenocarcinoma on histology?
A dense desmoplastic (fibrous) stroma.
What surgical procedure is used to resect a tumor in the head of the pancreas?
Whipple procedure (pancreaticoduodenectomy).

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