Lymphatic and Local Spread of T1 and T2 Pancreatic Cancer

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Abstract
Eight autopsy cases of pancreatic cancer (duct cell adenocarcinoma) with Tl and T2 primary tumors were studied histologically to examine the exact extent of lymphatic and local spread. Six of them had microscopic metastasis in grossly negative lymph nodes near the primary tumor. In addition, four of them had a few metastatic nodes in the para-aortic region. In cases with lymphatic metastases, the extent of cancer infiltration within lymphatic vessels, nerves, and/or connective tissues was almost the same as that of lymph node metastasis. Major vascular involvement was found in four cases. There was no case in which multicentricity or marked intraductal spread of cancer cells was observed in the pancreas. It has been suggested that most of Tl and T2 pancreatic cancers have a fairly widespread microscopic extension, although extremely small Tl cancers have a very limited extension.