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Liam Li of Ernst & Young LLP contributed to this article.

In this patient, the histological characteristics were consistent with those described in the literature, with the presence of small, round and pigmented cells, thus helping in the exclusion of other differential pathologies [12]

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Symptom-Triggered Testing Persistent severe abdominal pain: urgent evaluation, lipase testing, and appropriate imaging Right-upper-abdominal pain or jaundice: liver and biliary testing plus gallbladder imaging Persistent vomiting or diarrhea: kidney function and electrolyte testing Symptoms of hypoglycemia: immediate glucose evaluation Fatigue or signs of deficiency: CBC and selected nutritional tests Testing should not delay medical care for severe symptoms