@entity1823 with regional lymph node XXXX and a glandular component.

@entity1 @entity1353 @entity5 @entity3 @entity1823 @entity4607
@entity1823 ( @entity1823 ) is generally considered to be a benign periampullary lesion, although it is unclear whether it should be classified as a @entity4607 or as a @entity5 . Here, we present a @entity1823 case with lymph node @entity3 . A 16-year-old @entity1 complained of exertional @entity1353 . Upper endoscopy and imaging studies revealed a polypoid @entity5 . Pancreaticoduodenectomy with lymph node dissection was performed due to swelling of peripancreatic lymph nodes. Histologically, the @entity5 consisted of three cell types: epithelioid; spindle; and ganglion cells. In addition to these typical components of @entity1823 , a distinct glandular component was also present. There was substantial invasion of @entity5 cells into the lymphovascular vessels, associated with lymph node @entity3 . These lymph node @entity3 were histologically similar to the @entity5 . To judge from these findings @entity1823 may be a true @entity5 with metastatic capacity. Pre- and intraoperative investigations for lymph node or distant @entity3 are required for adequate resection of this kind of @entity5 .
