Skip to main content

Other Cystic Lesions of the Pancreas

  • Chapter
  • First Online:
Pancreas and Biliary Tract Cytohistology

Part of the book series: Essentials in Cytopathology ((EICP,volume 28))

  • 700 Accesses

Abstract

Pancreatic cyst lesions encompass a wide variety of entities ranging from nonneoplastic to neoplastic lesions with cystic degeneration. The cysts can show significant overlap in terms of imaging findings as well as clinical features. Cytology along with cyst fluid analysis plays a pivotal role in the preoperative characterization of these lesions. However, some lesions, especially the uncommon ones, may not be diagnosed accurately resulting in unnecessary surgery. This chapter will discuss the various aspects of pancreatic cystic lesions (other than the neoplastic mucinous cysts) including the clinical features, imaging findings, pathologic features, molecular genetics, and management.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Terris B, Fukushima N, Hruban RH. Serous neoplasms of the pancreas. In: Bosman FT, Carneiro F, Hruban RH, Theise ND, editors. WHO classification of tumors of the diagestive system. 4th ed. Lyon: IARC; 2010. p. 296–9.

    Google Scholar 

  2. Zhang XP, Yu ZX, Zhao YP, Dai MH. Current perspectives on pancreatic serous cystic neoplasms: diagnosis, management and beyond. World J Gastrointest Surg. 2016;8:202–11.

    Article  Google Scholar 

  3. Tseng JF, Warshaw AL, Sahani DV, Lauwers GY, Rattner DW, Fernandez-del Castillo C. Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment. Ann Surg. 2005;242:413–9.

    PubMed  PubMed Central  Google Scholar 

  4. Ishigami K, Nishie A, Asayama Y, Ushijima Y, Takayama Y, Fujita N, et al. Imaging pitfalls of pancreatic serous cystic neoplasm and its potential mimickers. World J Radiol. 2014;6:36–47. https://doi.org/10.4329/wjr.v6.i3.36.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Choi JY, Kim MJ, Lee JY, Lim JS, Chung JJ, Kim KW, et al. Typical and atypical manifestations of serous cystadenoma of the pancreas: imaging findings with pathologic correlation. AJR Am J Roentgenol. 2009;193:136–42. https://doi.org/10.2214/AJR.08.1309.

    Article  PubMed  Google Scholar 

  6. Belsley NA, Pitman MB, Lauwers GY, Brugge WR, Deshpande V. Serous cystadenoma of the pancreas: limitations and pitfalls of endoscopic ultrasound-guided fine-needle aspiration biopsy. Cancer. 2008;114:102–10. https://doi.org/10.1002/cncr.23346.

    Article  PubMed  Google Scholar 

  7. Lilo MT, VandenBussche CJ, Allison DB, Lennon AM, Younes BK, Hruban RH, et al. Serous cystadenoma of the pancreas: potentials and pitfalls of a preoperative cytopathologic diagnosis. Acta Cytol. 2017;61:27–33. https://doi.org/10.1159/000452471.

    Article  CAS  PubMed  Google Scholar 

  8. Salomao M, Remotti H, Allendorf JD, Poneros JM, Sethi A, Gonda TA, et al. Fine-needle aspirations of pancreatic serous cystadenomas: improving diagnostic yield with cell blocks and α-inhibin immunohistochemistry. Cancer Cytopathol. 2014;122:33–9.

    Article  Google Scholar 

  9. Kaur G, Bakshi P, Singla V, Verma K. Clear cell neuroendocrine tumor of pancreas: endoscopic ultrasound-guided fine needle aspiration diagnosis of an uncommon variant. Cytojournal. 2016;13:7. https://doi.org/10.4103/1742–6413.178995.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Reid MD, Saka B, Balci S, Goldblum AS, Adsay NV. Molecular genetics of pancreatic neoplasms and their morphologic correlates: an update on recent advances and potential diagnostic applications. Am J Clin Pathol. 2014;141:168–80.

    Article  CAS  Google Scholar 

  11. Kloppel G, Hruban RH, Klimstra DS, Maitra A, Morohoshi T, Notohara, et al. Solid pseudopapillary neoplasm of the pancreas. In: Bosman FT, Carneiro F, Hruban RH, Theise ND, editors. WHO classification of tumors of the digestive system. 4th ed. Lyon: IARC; 2010. p. 327–30.

    Google Scholar 

  12. Sunkara S, Williams TR, Myers DT, Kryvenko ON. Solid pseudopapillary tumours of the pancreas: spectrum of imaging findings with histopathological correlation. Br J Radiol. 2012;85:e1140–4. https://doi.org/10.1259/bjr/20695686.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Ohara Y, Oda T, Hashimoto S, Akashi Y, Miyamoto R, Enomoto T, et al. Pancreatic neuroendocrine tumor and solid-pseudopapillary neoplasm: key immunohistochemical profiles for differential diagnosis. World J Gastroenterol. 2016;22:8596–604.

    Article  CAS  Google Scholar 

  14. Burford H, Baloch Z, Liu X, Jhala D, Siegal GP, Jhala N. E-cadherin/beta-catenin and CD10: a limited immunohistochemical panel to distinguish pancreatic endocrine neoplasm from solid pseudopapillary neoplasm of the pancreas on endoscopic ultrasound-guided fine-needle aspirates of the pancreas. Am J Clin Pathol. 2009;132:831–9.

    Article  CAS  Google Scholar 

  15. Singhi AD, Lilo M, Hruban RH, Cressman KL, Fuhrer K, Seethala RR. Overexpression of lymphoid enhancer-binding factor 1 (LEF1) in solid-pseudopapillary neoplasms of the pancreas. Mod Pathol. 2014;27:1355–63.

    Article  CAS  Google Scholar 

  16. Singhi AD, Chu LC, Tatsas AD, Shi C, Ellison TA, Fishman EK, et al. Cystic pancreatic neuroendocrine tumors: a clinicopathologic study. Am J Surg Pathol. 2012;36:1666–73. https://doi.org/10.1097/PAS.0b013e31826a0048.

    Article  PubMed  Google Scholar 

  17. Yoon WJ, Daglilar ES, Pitman MB, Brugge WR. Cystic pancreatic neuroendocrine tumors: endoscopic ultrasound and fine-needle aspiration characteristics. Endoscopy. 2013;45:189–94. https://doi.org/10.1055/s-0032–1325990.

    Article  CAS  PubMed  Google Scholar 

  18. Morales-Oyarvide V, Yoon WJ, Ingkakul T, Forcione DG, Casey BW, Brugge WR, et al. Cystic pancreatic neuroendocrine tumors: the value of cytology in preoperative diagnosis. Cancer Cytopathol. 2014;122:435–44. https://doi.org/10.1002/cncy.21403.

    Article  CAS  PubMed  Google Scholar 

  19. Cloyd JM, Kopecky KE, Norton JA, Kunz PL, Fisher GA, Visser BC, et al. Neuroendocrine tumors of the pancreas: degree of cystic component predicts prognosis. Surgery. 2016;160:708–13. https://doi.org/10.1016/j.surg.2016.04.005.

    Article  PubMed  Google Scholar 

  20. Ridtitid W, Halawi H, DeWitt JM, Sherman S, LeBlanc J, McHenry L, et al. Cystic pancreatic neuroendocrine tumors: outcomes of preoperative endosonography-guided fine needle aspiration, and recurrence during long-term follow-up. Endoscopy. 2015;47:617–25. https://doi.org/10.1055/s-0034–1391712.

    Article  PubMed  Google Scholar 

  21. Gonzalez Obeso E, Murphy E, Brugge W, Deshpande V. Pseudocyst of the pancreas: the role of cytology and special stains for mucin. Cancer. 2009;117:101–7.

    PubMed  Google Scholar 

  22. Aghdassi AA, Mayerle J, Kraft M, Sielenkämper AW, Heidecke CD, Lerch MM. Pancreatic pseudocysts—when and how to treat? HPB (Oxford). 2006;8:432–41. https://doi.org/10.1080/13651820600748012.

    Article  Google Scholar 

  23. Policarpio-Nicolas ML, Shami VM, Kahaleh M, Adams RB, Mallery S, Stanley MW, et al. Fine-needle aspiration cytology of pancreatic lymphoepithelial cysts. Cancer. 2006;108:501–6.

    Article  Google Scholar 

  24. Raval JS, Zeh HJ, Moser AJ, Lee KK, Sanders MK, Navina S, et al. Pancreatic lymphoepithelial cysts express CEA and can contain mucous cells: potential pitfalls in the preoperative diagnosis. Mod Pathol. 2010;23:1467–76. https://doi.org/10.1038/modpathol.2010.144.

    Article  CAS  PubMed  Google Scholar 

  25. Adsay NV, Hasteh F, Cheng JD, Klimstra DS. Squamous-lined cysts of the pancreas: lymphoepithelial cysts, dermoid cysts (teratomas), and accessory-splenic epidermoid cysts. Semin Diagn Pathol. 2000;17:56–65.

    CAS  PubMed  Google Scholar 

  26. Zavras N, Machairas N, Foukas P, Lazaris A, Patapis P, Machairas A. Epidermoid cyst of an intrapancreatic accessory spleen: a case report and literature review. World J Surg Oncol. 2014;12:92. https://doi.org/10.1186/1477–7819–12–92.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Horn AJ, Lele SM. Epidermoid cyst occurring within an intrapancreatic accessory spleen. A case report and review of the literature. JOP. 2011;12:279–82.

    PubMed  Google Scholar 

  28. Othman M, Basturk O, Groisman G, Krasinskas A, Adsay NV. Squamoid cyst of pancreatic ducts: a distinct type of cystic lesion in the pancreas. Am J Surg Pathol. 2007;31:291–7.

    Article  Google Scholar 

  29. Hanson JA, Salem RR, Mitchell KA. Squamoid cyst of pancreatic ducts: a case series describing novel immunohistochemistry, cytology, and quantitative cyst fluid chemistry. Arch Pathol Lab Med. 2014;138:270–3. https://doi.org/10.5858/arpa.2012–0667-CR.

    Article  PubMed  Google Scholar 

  30. Singhi AD, Norwood S, Liu TC, Sharma R, Wolfgang CL, Schulick RD, et al. Acinar cell cystadenoma of the pancreas: a benign neoplasm or non-neoplastic ballooning of acinar and ductal epithelium? Am J Surg Pathol. 2013;37:1329–35. https://doi.org/10.1097/PAS.0b013e3182a1ad72.

    Article  PubMed  Google Scholar 

  31. Chen AL, Misdraji J, Brugge WR, Ferrone CR, Pitman MB. Acinar cell cystadenoma: a challenging cytology diagnosis, facilitated by moray® micro-forceps biopsy. Diagn Cytopathol. 2017;45:557–60. https://doi.org/10.1002/dc.23693.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Abha Goyal .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Goyal, A. (2019). Other Cystic Lesions of the Pancreas. In: Goyal, A., Rao, R., Siddiqui, M. (eds) Pancreas and Biliary Tract Cytohistology. Essentials in Cytopathology, vol 28. Springer, Cham. https://doi.org/10.1007/978-3-030-22433-2_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-22433-2_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-22432-5

  • Online ISBN: 978-3-030-22433-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics