Slide 4

This is a higher power view of a malignant gland.  It is lined by pleomorphic cells which pile-up to form secondary lumina (gland-within-gland formation).  Bridges of neoplastic epithelium grow across the major lumen of the gland (arrow).

Slide 5

At higher magnification, note the nuclear pleomorphism of the neoplastic cells lining the glands.

Slide 6
Perineural invasion is extremely common in carcinoma of the pancreas.  Unfortunately, infiltration into the peripancreatic fat, mesenteric vessels, duodenal wall, common bile duct, and other contiguous structures such as the stomach, spleen, portal vein, peritoneal cavity is also common.  Regional lymph node metastases are almost always present at the time of diagnosis.