scholarly journals Diagnosis and Management of Cystic Lesions of the Pancreas

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Niraj Jani ◽  
Murad Bani Hani ◽  
Richard D. Schulick ◽  
Ralph H. Hruban ◽  
Steven C. Cunningham
Keyword(s):  
Pancreatic Pseudocyst ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Pancreatic Cysts ◽  
Ethanol Ablation ◽  
Fluid Analysis ◽  
Serous Cystic Neoplasm ◽  
Papillary Neoplasm ◽  
Associated Mass

Pancreatic cysts are challenging lesions to diagnose and to treat. Determining which of the five most common diagnoses—pancreatic pseudocyst, serous cystic neoplasm (SCN), solid pseudopapillary neoplasm (SPN), mucinous cystic neoplasm (MCN), and intraductal mucinous papillary neoplasm (IPMN)—is likely the correct one requires the careful integration of many historical, radiographic, laboratory, and other factors, and management is markedly different depending on the type of cystic lesion of the pancreas. Pseudocysts are generally distinguishable based on historical, clinical and radiographic characteristics, and among the others, the most important differentiation is between the mucin-producing MCN and IPMN (high risk for cancer) versus the serous SCN and SPN (low risk for cancer). EUS with FNA and cyst-fluid analysis will continue to play an important role in diagnosis. Among mucinous lesions, those that require treatment (resection currently) are any MCN, any MD IPMN, and BD IPMN larger than 3 cm, symptomatic, or with an associated mass, with the understanding that SCN or pseudocysts may be removed inadvertently due to diagnostic inaccuracy, and that a certain proportion of SPN will indeed be malignant at the time of removal. The role of ethanol ablation is under investigation as an alternative to resection in selected patients.

A nomogram for predicting pancreatic mucinous cystic neoplasm and serous cystic neoplasm

2021 ◽  
Author(s):  
Chengwei Shao ◽  
Xiaochen Feng ◽  
Jieyu Yu ◽  
Yinghao Meng ◽  
Fang Liu ◽  
...  
Keyword(s):  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Serous Cystic Neoplasm

Anaplastic Carcinoma Arising in a Mucinous Cystic Neoplasm Masquerading as Pancreatic Pseudocyst

2016 ◽  
Vol 44 (6) ◽  
pp. 538-542 ◽  
Author(s):  
Najla Aldaoud ◽  
Amani Joudeh ◽  
Sami Al-Momen ◽  
Mamdouh Alnahawi ◽  
Mousa A. Al-Abbadi
Keyword(s):  
Pancreatic Pseudocyst ◽  
Mucinous Cystic Neoplasm ◽  
Anaplastic Carcinoma ◽  
Cystic Neoplasm

A case of mucinous cystic neoplasm of the pancreas misdiagnosed as a pancreatic pseudocyst at the initial exam and resected after a 2-year follow-up

2014 ◽  
Vol 42 (2) ◽  
pp. 257-265 ◽  
Author(s):  
Takuya Ishikawa ◽  
Jun-ichi Haruta ◽  
Takeo Yamaguchi ◽  
Masao Doisaki ◽  
Tsuyoki Yama ◽  
...  
Keyword(s):  
Pancreatic Pseudocyst ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm

scholarly journals Cytologic Assessment of Cystic/Intraductal Lesions of the Pancreatobiliary Tract

2021 ◽  
Author(s):  
Michelle D. Reid
Keyword(s):  
Fine Needle Aspiration ◽  
Intraductal Papillary Mucinous Neoplasm ◽  
Imaging Techniques ◽  
Mucinous Cystic Neoplasm ◽  
Needle Aspiration ◽  
Cyst Fluid ◽  
Cystic Neoplasm ◽  
Pancreatic Cysts ◽  
Fine Needle ◽  
Mucinous Neoplasm

Context.— Because of new and improved imaging techniques, cystic/intraductal pancreatobiliary tract lesions are increasingly being discovered, and brushings or endoscopic ultrasound/computed tomography/magnetic resonance imaging–guided fine-needle aspiration biopsies from these lesions have become an integral part of pathologists' daily practice. Because patient management has become increasingly conservative, accurate preoperative diagnosis is critical. Cytologic distinction of low-risk (pseudocysts, serous cystadenoma, lymphoepithelial cysts, and squamoid cysts of the pancreatic duct) from high-risk pancreatic cysts (intraductal papillary mucinous neoplasm and mucinous cystic neoplasm) requires incorporation of clinical, radiologic, and cytologic findings, in conjunction with chemical and molecular analysis of cyst fluid. Cytopathologists must ensure appropriate specimen triage, along with cytologic interpretation, cyst classification, and even grading of some (mucinous) cysts. Epithelial atypia in mucinous cysts (intraductal papillary mucinous neoplasm and mucinous cystic neoplasm) has transitioned from a 3-tiered to a 2-tiered classification system, and intraductal oncocytic papillary neoplasms and intraductal tubulopapillary neoplasms have been separately reclassified because of their distinctive clinicopathologic characteristics. Because these lesions may be sampled on brushing or fine-needle aspiration biopsy, knowledge of their cytomorphology is critical. Objective.— To use an integrated, multidisciplinary approach for the evaluation of cystic/intraductal pancreatobiliary tract lesions (incorporating clinical, radiologic, and cytologic findings with [chemical/molecular] cyst fluid analysis and ancillary stains) for definitive diagnosis and classification. Data Sources.— Review of current literature on the cytopathology of cystic/intraductal pancreatobiliary tract lesions. Conclusions.— Our knowledge/understanding of recent updates in cystic/intraductal pancreatobiliary lesions can ensure that cytopathologists appropriately triage specimens, judiciously use and interpret ancillary studies, and incorporate the studies into reporting.

scholarly journals European evidence-based guidelines on pancreatic cystic neoplasms

Gut ◽  
2018 ◽  
Vol 67 (5) ◽  
pp. 789-804 ◽  
Author(s):  
Keyword(s):  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Evidence Based ◽  
Indications For Surgery ◽  
Cystic Neoplasms ◽  
Serous Cystic Neoplasm ◽  
Pancreatic Cystic Neoplasms ◽  
Grade Methodology ◽  
Evidence Based Guidelines

Evidence-based guidelines on the management of pancreatic cystic neoplasms (PCN) are lacking. This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, United European Gastroenterology, European Pancreatic Club, European-African Hepato-Pancreato-Biliary Association, European Digestive Surgery, and the European Society of Gastrointestinal Endoscopy. It replaces the 2013 European consensus statement guidelines on PCN. European and non-European experts performed systematic reviews and used GRADE methodology to answer relevant clinical questions on nine topics (biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm, rare cysts, (neo)adjuvant treatment, and pathology). Recommendations include conservative management, relative and absolute indications for surgery. A conservative approach is recommended for asymptomatic MCN and IPMN measuring <40 mm without an enhancing nodule. Relative indications for surgery in IPMN include a main pancreatic duct (MPD) diameter between 5 and 9.9 mm or a cyst diameter ≥40 mm. Absolute indications for surgery in IPMN, due to the high-risk of malignant transformation, include jaundice, an enhancing mural nodule >5 mm, and MPD diameter >10 mm. Lifelong follow-up of IPMN is recommended in patients who are fit for surgery. The European evidence-based guidelines on PCN aim to improve the diagnosis and management of PCN.

The role of cytopathology and cyst fluid analysis in the preoperative diagnosis and management of pancreatic cysts >3 cm

2014 ◽  
Vol 122 (11) ◽  
pp. 804-809 ◽  
Author(s):  
Ivan Chebib ◽  
Kurt Yaeger ◽  
Mari Mino-Kenudson ◽  
Martha B. Pitman
Keyword(s):  
Preoperative Diagnosis ◽  
Cyst Fluid ◽  
Pancreatic Cysts ◽  
Diagnosis And Management ◽  
Fluid Analysis

Ciliated Enteric Duplication Cyst Presenting as A Pancreatic Cystic Neoplasm: Report of A Case with Cyst Fluid Analysis

1992 ◽  
Vol 38 (8) ◽  
pp. 1501-1503 ◽  
Author(s):  
M R Pins ◽  
C C Compton ◽  
J F Southern ◽  
D W Rattner ◽  
K B Lewandrowski
Keyword(s):  
Duplication Cyst ◽  
Cyst Fluid ◽  
Ca 125 ◽  
Cystic Neoplasm ◽  
Pancreatic Cysts ◽  
Fluid Viscosity ◽  
Pancreatic Cystic Neoplasm ◽  
Fluid Analysis ◽  
Enteric Duplication Cyst ◽  
Enteric Duplication

Abstract Pancreatic cysts include inflammatory pseudocysts, cystic tumors (serous and mucinous), and various rare cystic lesions. We report a case of a ciliated enteric duplication cyst that presented on computed tomographic scan as a pancreatic cystic neoplasm. Cyst fluid analysis revealed markedly increased concentrations of carcinoembryonic antigen and CA 125 and increased fluid viscosity. These features are typical for a mucinous cystic neoplasm of the pancreas and demonstrate a potential pitfall associated with the diagnosis of pancreatic cysts by chemical analyses. Enteric duplications involving the pancreas are rare, usually of gastric origin, and usually communicate with their enteric source. Morphological and histochemical analysis suggest that this cyst was of caudal foregut origin. This is the first reported case of a ciliated foregut cyst involving the pancreas. The chemical characteristics of the cyst fluid of these lesions have not been described previously.

scholarly journals A Serous Cystic Neoplasm of the Pancreas with Synchronous Pancreatic Ductal Adenocarcinoma

2020 ◽  
Vol 25 (2) ◽  
pp. 118-122
Author(s):  
Hyun Jin Park ◽  
Jun Seong Hwang ◽  
Sung Woo Ko ◽  
Hoonsub So ◽  
Jae Woo Kwon ◽  
...  
Keyword(s):  
Literature Review ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Mucinous Cystic Neoplasm ◽  
Malignant Potential ◽  
Ductal Adenocarcinoma ◽  
Cystic Neoplasm ◽  
Solitary Lesion ◽  
Mucinous Neoplasm ◽  
Serous Cystic Neoplasm ◽  
Cystic Pancreatic Lesions

Serous cystic neoplasm (SCN) represents 10–16% of cystic pancreatic lesions, first classified by Compagno and Oertel at 1978. In contrast to mucinous cystic neoplasm or intraductal papillary mucinous neoplasm of pancreas which have malignant potential, SCN is thought to be exclusively benign as solitary lesion in nearly all cases. There has been rare reported association between the SCN and pancreatic ductal adenocarcinoma, and few cases were documented their coexistence. In this report, we present the case of SCN of the pancreas with literature review in which synchronous pancreatic ductal adenocarcinoma and pancreatic intraepithelial neoplasm coexist together.

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