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Fine needle aspiration cytology diagnosis of a pancreatoblastoma in an infant: case report with a summary of prior published cases

Pancreatoblastoma (PBL) is an uncommon malignant pancreatic tumour characterised by neoplastic cells with acinar differentiation and distinctive squamoid nests. Although the tumour is rare, it is one of the most common pancreatic tumours in childhood. The median age at presentation is 4 years. It should be differentiated from other embryonic tumours and some tumour-like conditions of the pancreas (e.g. nesidioblastosis), as well as from other abdominal tumours in infancy (e.g. Wilms’ tumour and neuroblastoma). Differentiation of a PBL from other tumours is extremely important as the prognosis of the former is good, when resected completely. Fine needle aspiration cytology (FNAC) is the mainstay of diagnosis of paediatric abdominal tumours and chemotherapy is usually started based on the FNAC reports alone. Although several cases of PBL have been reported in the literature, only four cases have been diagnosed on FNAC/imprint cytology, and none have been reported in infants, on FNAC. We came across a 11-month-old boy who presented with an epigastric swelling, and underwent FNAC. Based upon the cytological features, a diagnosis of PBL was suggested and was later confirmed on histology. Here we report the FNAC findings of a PBL in an infant along with its morphological differential diagnoses.