Cyst Fluid Cytology and Chemical Features in a Case of Lymphoepithelial Cyst of the Pancreas: A Rare and Difficult Preoperative Diagnosis

Most pancreatic cysts (90%) are inflammatory pseudocysts. Approximately 10% of pancreatic cysts are neoplasms, including serous cystadenomas, and mucinous tumors, some of which are malignant. Analysis of pancreatic cyst fluid obtained by percutaneous or endoscopic fine‐needle aspiration is increasin...

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Bibliographic Details
Published in:Diagnostic cytopathology 1999-11, Vol.21 (5), p.328-330
Main Authors: Centeno, Barbara A., Stockwell, James W., Lewandrowski, Kent B.
Format: Article
Language:English
Subjects:
Amylases - metabolism
Biological and medical sciences
Biomarkers, Tumor - metabolism
Cyst Fluid - cytology
Cyst Fluid - enzymology
Cyst Fluid - metabolism
cyst fluid analysis
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Lymphocytes - pathology
lymphoepithelial cyst
Male
Medical sciences
Middle Aged
pancreas
Pancreatic Cyst - enzymology
Pancreatic Cyst - metabolism
Pancreatic Cyst - pathology
Tumors
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Summary:Most pancreatic cysts (90%) are inflammatory pseudocysts. Approximately 10% of pancreatic cysts are neoplasms, including serous cystadenomas, and mucinous tumors, some of which are malignant. Analysis of pancreatic cyst fluid obtained by percutaneous or endoscopic fine‐needle aspiration is increasingly being used for the preoperative diagnosis of pancreatic or peripancreatic cysts. However, cyst fluid chemical and cytologic features in less common types of pancreatic cysts have not been reported. Lymphoepithelial cyst of the pancreas is exceedingly rare, and only occasional individual reports have described cyst fluid findings. We report on a case of lymphoepithelial cyst of the pancreas developing in a middle‐aged man. Cyst fluid aspirated under radiological guidance showed elevated levels of carcinoembryonic antigen (CEA), CA19‐9, CA 125, and amylase, and a viscosity greater than that of serum. A cell block preparation of a fine‐needle aspiration showed tissue fragments with a keratinized squamous lining and a lymphocytic infiltrate in the wall, and abundant background keratinous debris. The cytologic and biochemical findings in this case exhibit similarities to the findings reported in other reports, and may represent a recognizable pattern on cyst fluid analysis. Diagn. Cytopathol. 1999;21:328–330. © 1999 Wiley‐Liss, Inc.
ISSN:8755-1039
1097-0339
DOI:10.1002/(SICI)1097-0339(199911)21:5<328::AID-DC6>3.0.CO;2-J