Histopathological Analysis of Whipple Resection Specimens in a Local Population

Anam Ilyas, Sobia Anwar, Sadaf Ali Jaffari, Sadia Sharif, Asma Rasheed and
Lubna Humayun

ABSTRACT

Objective: Our aim was to study the and histopathological findings and distribution of these tumors and to observe local trends of periampullary neoplasms in Whipple resection specimens.

Study Design: A descriptive study

Place and Duration of Study: This study was conducted at the Department of Pathology University College of Medicine and Dentistry, University of Lahore from June 2023 to December 2023.

Methods: Whipple samples received in histopathology department because of different clinical presentations were included in the study. The histological preparation was performed by classical method for inclusion in paraffin followed by hematoxylin–eosin staining.

Results: Thirty patients underwent Whipple’s Pancreatoduodenectomy procedure during a period of 6 months from June 2023 to December 2023. Out of these thirty Whipple specimens, malignancy was found in 29 patients (96.67%) and 1 (3.33%) case was diagnosed as benign. Periampullary Adenocarcinoma was the most common tumor (36.66%) than Duodenal Adenocarcinoma (23.33%), followed by Pancreatic Adenocarcinoma (20%) and distal CBD Cholangiocarcinoma (13.33%). Two of the cases (6.66%) were diagnosed Neuroendocrine tumor on biopsy which were clinically established as a pancreatic malignancy. Tumor size was not significantly different in all these tumors. Four out of six pancreatic adenocarcinomas displayed lymphovascular and perineural invasion. Surgical margin was clear in majority of the cases excluding one case of pancreatic adenocarcinoma and two cases of periampullary duodenal carcinoma.

Conclusion: A detailed histopathological examination should be done in all Whipple resection specimens. Pathologists should also be conscious of possibility of a benign diagnosis in PD specimens which have been resected assuming malignancy based on clinico- radiological findings.

Key Words: pancreatoduodenectomy, whipple, neuroendocrine, pathologic stage.

Citation of article: Ilyas A, Anwar S, Jaffari SA, Sharif S, Rasheed A, Humayun L. Histopathological Analysis of Whipple Resection Specimens in a Local Population. Med Forum 2024;35(11):60-63. doi:10.60110/medforum.351112.