A 72-year-old woman presents with progressively worsening epigastric pain. A 4 x 2 x 2 periampullary duodenal mass is resected. The mass invades through the duodenal wall and involves regional lymph nodes.
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Toshi Ghosh, M.D.
Resident, Division of Anatomic and Clinical Pathology
Thomas Smyrk, M.D.
Consultant, Division of Anatomic Pathology
Professor of Laboratory Medicine and Pathology,
Mayo Clinic College of Medicine