A 58-year-old man presents with weight loss, new-onset diabetes, and steatorrhea. CT shows a pancreatic body mass. Biopsy reveals tumor cells arranged in acinar pattern with granular eosinophilic cytoplasm. PAS-positive and diastase-resistant cytoplasmic granules are seen. Which serum marker is most likely elevated?
- A CA 19-9
- B Lipase ✓
- C CEA
- D AFP
Correct answer: B. Lipase
Explanation
This describes acinar cell carcinoma of the pancreas, a rare exocrine tumor that produces pancreatic enzymes. Serum lipase is elevated and can be used as a tumor marker. The acinar architecture and PAS-positive, diastase-resistant zymogen granules are characteristic. CA 19-9 is elevated in ductal adenocarcinoma. CEA is a nonspecific marker. AFP is elevated in hepatocellular carcinoma and yolk sac tumors. Acinar cell carcinoma is associated with subcutaneous fat necrosis and polyarthritis.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.