February 2016

Authors: James Lee MD and Christopher J. VandenBussche MD PhD
Department of Pathology, The Johns Hopkins University School of Medicine

A 47 year old female with severe diarrhea and an elevated vasoactive intestinal peptide (VIP) level underwent imaging studies, which identified a 3 cm hyperenhancing density in the tail of her pancreas. She underwent endoscopic ultrasound-guided fine needle aspiration (FNA) of this mass, and the following pictures are representative of the smears and cell block material created from the FNA (Figures 1-5).

Fig 1 2016 February
Fig. 1
Fig 2 2016 February
Fig 3 2016 February
Fig. 3
Fig 4 2016 February
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Fig 5 2016 February
Fig. 5
Which of the following is the best answer?