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. 2022 Jun 22;21:133. doi: 10.1186/s12943-022-01596-8

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© The Author(s) 2022

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 1 — Imaging and pathological analysis of pca_ai1 patient. A-C, CT images. Dedicated abdominal CT found an enlarging exophytic 4.5-cm pancreatic head mass (white arrow) with focal calcification (black arrowhead, A). The lesion showed heterogenous low intensity in the edge (arrow, B) relative to pancreatic parenchyma in the pancreatic and portal vein phases with directly protruding into the adjacent superior mesenteric vein (arrow, C). D, MRI analysis. A filling defect in the main pancreatic duct (MPD) of the pancreatic head and dilation of the MPD distal to the lesion are evident in MRI, and indicated by arrows in D. E, Representative images of H&E staining of surgical removed pancreatic tissue of pca_ai1. Arrows indicated osteoclast-like giant cells (OGCs). F-I, Representative images of IHC staining of surgical removed pancreatic tissue of pca_ai1. pan-cytokeratin (CKpan) (F), Ki67 (G), p53 (H), and CD68 (I) were used to indicate pleomorphic neoplastic cells and OGCs. Arrows in H indicated osteoclast-like giant cells (OGCs) with CD68 positive staining. Bar = 200 µm