Adenocarcinomas with intestinal differentiation have been described in a wide variety of anatomical sites. To our knowledge, however, ductal
adenocarcinomas with intestinal phenotype have not been described in the pancreas. We report here 11
ductal carcinomas of the pancreas that were morphologically similar to colonic
adenocarcinomas. These
pancreatic carcinomas of intestinal type represented 10% of 110 consecutively removed
ductal carcinomas of the pancreas. All intestinal type
carcinomas expressed
cytokeratin 7,
carcinoembryonic antigen, CDX2, and MUC2. The pattern of reactivity of
cytokeratin 7 and
carcinoembryonic antigen was diffuse, whereas that of
mucin 2 staining and CDX2 nuclear labeling was focal and confined predominantly to goblet cells and less frequently to columnar cells. Six
carcinomas contained collections of endocrine cells admixed with the columnar and goblet cells. Five
carcinomas were associated with high-grade pancreatic intraepithelial
neoplasia of intestinal type. Six patients were female and 5 were male. Their ages ranged from 52 to 76 years (mean age, 61 years). The clinical presentation did not differ from that of the conventional
ductal carcinomas. All
carcinomas originated in the head of the pancreas, and 5 had metastasized to the regional lymph nodes at the time of surgical resection. Only 1 patient survived 5 years. Three patients are disease free from 2.8 to 8.9 months after surgery. Six patients died as a direct result of the
carcinomas, and 1 was lost to follow-up. More studies are needed to determine the biologic behavior of this distinctive histologic variant of ductal
adenocarcinoma of the pancreas.