Abdominal lymphocele misdiagnosed as pancreatic cystic lesion, report of two cases. EUS features, accuracy, safety and role of preoperative FNA

Introduction Frequency of detection of pancreatic cystic lesions increased recent years. The majorities are pseudocysts, the remaining cysts are mainly neoplasms. Proven risk of malignancy affects intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms (MCN). Material and methods 145 patients operated on at the Department of General and Transplant Surgery in Barlicki Hospital in Lodz, Poland, in 2007-2016 due to pancreatic cystic lesion. The type of surgery, histopathological diagnosis and basic demographic data were analyzed. Results Nonneoplastic cyst (mainly pseudocysts) was found in 66.9% of patients, neoplasms were detected in 33.1%. The mean age was significantly higher in patients with neoplasms than without neoplasm (57.06 years vs. 50.88 years, p = 0.009). Neoplastic cyst occurred more frequently in women (68.75% of women, 31.25% of men, p = 0.001), Nonneoplastic cyst was found significantly more often in men (64.95% of men, 35.05% of women, p = 0.001). Malignant tumor was found in 14.58% of neoplasms cases. Pancreatic resections in neoplastic cysts were performed in 77,08%. In patients with nonneoplastic cysts drainage operations were performed most frequently (80.41%). Conclusions Neoplastic cysts are more common in women. The average age in the group of patients with neoplasms is higher than in the group with nonneoplastic cysts. In women with pancreatic cystic lesion without history for pancreatitis, the probability of neoplasms diagnosis is high. Discussion Pancreatic cystic tumors are treated radically due to the lack of sufficiently sensitive and specific pre-operative examinations. The natural history of mucinous neoplasms (IPMN and MCN) ranges from dysplasia to cancer. There are no guidelines that could be in satisfactory way used in follow up patients with pancreatic cysts.

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Abdominal desmoid in familial adenomatous polyposis presenting as a pancreatic cystic lesion

Familial Cancer ◽

10.1007/s10689-004-1923-z ◽

2005 ◽

Vol 4 (2) ◽

pp. 135-138 ◽

Cited By ~ 17

Author(s):

Lana N. Pho ◽

Cheryl M. Coffin ◽

Randall W. Burt

Keyword(s):

Familial Adenomatous Polyposis ◽

Cystic Lesion ◽

Adenomatous Polyposis ◽

Pancreatic Cystic Lesion

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183 Laparoscopic Resection of Pancreatic Cystic Lesion

Journal of Gastrointestinal Surgery ◽

10.1016/s1091-255x(02)00386-4 ◽

2003 ◽

Vol 7 (2) ◽

pp. 315

Author(s):

Y Mou

Keyword(s):

Cystic Lesion ◽

Laparoscopic Resection ◽

Pancreatic Cystic Lesion

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Cystic lesions of pancreas: challenges in diagnosis and management

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v18i3.15315 ◽

2016 ◽

Vol 18 (3) ◽

pp. 53

Author(s):

S Bohara ◽

TY Tamang ◽

DK Maharjan ◽

SK Shrestha ◽

PB Thapa

Keyword(s):

Cystic Lesion ◽

Mucinous Cystadenoma ◽

Pancreatic Head ◽

College Teaching ◽

Serous Cystadenoma ◽

Pancreatic Tumors ◽

Pancreatic Cysts ◽

Cystic Lesions ◽

Pancreatic Cystic Lesion ◽

First Case

Introduction: Pancreatic cysts are common (2.5%). Cystic neoplasms represent 10% of cystic lesions and 1% of pancreatic tumors. However, it is difficult to differentiate benign cyst from malignant cystic lesions preoperatively.Objective: To study the cases of pancreatic cystic lesion who underwent various forms of pancreatic resection.Materials and Methods: Nine cases of pancreatic cystic lesion who presented to Kathmandu Medical College Teaching Hospital, Surgical Unit 3 within December 2014- November 2015 were evaluated. Four pancreatic cysts who underwent resection are discussed whereas not managed with resection are excluded.Results: There were 4 cases of pancreatic cyst who underwent pancreatic resection. First case underwent pancreaticoduodenectomy for pancreatic mucinous cystadenoma. However histopathological examination revealed a serous cystadenoma. In second case, pancreatic neck lesion suspected to be mucinous cystadenoma or pseudocyst in MRCP, with negative malignant cells in EUS guided FNAC underwent Central pancreatectomy and was found to be serous cystadenoma. The third case with suspected pseudocyst underwent Pancreaticoduodenectomy after a 3X2 cm2 cystic mass was felt at the posteroinferior side of pancreatic head and malignancy was suspected intraoperatively . HPE report was mucinous cystadenoma. The fourth case with pancreatic pseudocyst at tail with duct calculi and chronic pancreatitis underwent distal pancreatectomy with splenectomy with Frey’s procedure.Conclusion: Management of pancreatic cystic lesion is challenging. Though radiological imaging has limited role in accurate diagnosis, endoscopic ultrasound may be of some benefit.

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Ultrasound Diagnosis of Infantile Axillary Cystic Hygroma

Asian Journal of Allied Health Sciences (AJAHS) ◽

10.52229/ajahs.v1i1.276 ◽

2020 ◽

pp. 23-27

Author(s):

OJS Admin

Keyword(s):

Cystic Lesion ◽

Neck Region ◽

Cystic Hygroma ◽

Cystic Lymphangioma ◽

Radiology Department ◽

International Studies ◽

Cystic Lesions ◽

Axillary Region ◽

Ct And Mri

Cystic hygroma or cystic lymphangioma is a rare d e v e l o p m e n t a l c o n g e n i t a l l y m p h a t i c malformation. It is most commonly related to thorax and neck region but it can also involve axilla, mediastinum, limbs and face. It is characterized by multiloculated cystic lesion of variable sizes. Ultrasound is very important in the diagnosis of prenatal cystic hygroma but it is also important in the characterization and differential diagnosis of cystic hygroma postnatally. In radiology department CT and MRI is done for the differentiation of cystic hygroma from other cystic lesions but due to the hazardous effects of these modalities it is important to give preference to ultr a s ound i n t h e di a g n o s i s o f c y s ti c lymphangioma. Some international studies are available on the cystic hygroma of the axillary region in infants but no local studies are published on the role of ultrasound in the diagnosis of cystic hygroma in infants.

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