Lymphoepithelial cyst of the pancreas

Takamatsu, Susumu; Maruyama, Michio; Sugano, Norihide; Ebuchi, Masakazu

doi:10.1007/bf02349797

Cited by 6 publications

(3 citation statements)

References 14 publications

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“…A malignant transformation of LEC has not been reported, epithelial changes are often reactive due to secondary in ammation of the cyst. The elevation of tumor markers is not a distinctive clinical feature of malignancy as around 30-40% of LEC showed elevated CEA and CA 19 − 9 levels being benign lesions (24).…”

Section: Discussionmentioning

confidence: 99%

Lymphoepithelial Cyst of the Pancreas: Can Common Imaging Features Help to Avoid Resesction?

Khristenko

García

Gaida

et al. 2021

Preprint

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Background: Differentiation of cystic pancreatic neoplasms remains a challenging task for radiologists with main aim of characterizing malignant and premalignant conditions. Purpose: The study aimed to compare radiological features of lymphoepithelial cysts (LEC) with other cystic pancreatic lesions, which could help to differentiate them in order to avoid unnecessary resection and optimize surveillance.Material and Methods: We retrospectively reviewed 12 cases of resected and histopathological confirmed LECs in last 12 years, for 10 patients imaging studies were available. 20 patients with mucinous cystic neoplasms (MCN) and 20 patients with branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) were selected consecutively to serve as control groups. Imaging findings as well as clinical data were analyzed. Results: Three imaging subtypes of LEC were identified: simple cystic morphology (20%) and mixed cystic-solid lesions (80%) with either diffuse subsolid component (30%) or mural nodule (50%). All lesions revealed exophytic location with strong male predominance (9:1). MCNs were presented exclusively in middle-aged woman and IPMN in both sexes showing slight male predominance (13:7). Mean patient age in IPMN (70.5+7.7 years) was significantly higher compared to other groups (p<0.001 for LEC, p=0.005 for MCN). Unenhanced CT-attenuation of LEC was higher than MCNs (p=0.025) and IPMNs (p=0.021). Conclusion: The present study provides three imaging subtypes of LEC with key features for the differentiation from other cystic pancreatic lesions such as increased native attenuation, absence of connection to main pancreatic duct (MPD) and exophytic location. Clinical data, such as male predominance in LEC, is crucial in differentiating cystic pancreatic lesions.

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Section: Discussionmentioning

confidence: 99%

Lymphoepithelial Cyst of the Pancreas: Can Common Imaging Features Help to Avoid Resesction?

Khristenko

García

Gaida

et al. 2021

Preprint

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“…A malignant transformation of LEC has not been reported; epithelial changes are often reactive due to secondary inflammation of the cyst. The elevation of tumor markers is not a distinctive clinical feature of malignancy as around 30–40% of LEC showed elevated CEA and CA 19–9 levels being benign lesions [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Lymphoepithelial cyst of the pancreas: can common imaging features help to avoid resection?

Khristenko

García²,

Gaida

et al. 2023

Langenbecks Arch Surg

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Background Differentiation of cystic pancreatic neoplasms remains a challenging task for radiologists regarding the main aim of identifying malignant and premalignant lesions. Purpose The study aimed to compare the radiological features of lymphoepithelial cysts (LEC) with other cystic pancreatic lesions, which could help to differentiate them in order to avoid unnecessary resection. Material and methods We retrospectively reviewed 10 cases of resected and histopathologically confirmed LECs during a 12-year period with available imaging studies; 20 patients with mucinous cystic neoplasms (MCN), 20 patients with branch-duct intraductal papillary mucinous neoplasms (BD-IPMN), and 20 patients with serous cystic neoplasms (SCN) were selected to serve as control groups. Imaging findings as well as clinical data were analyzed. Results The following imaging morphology of LEC was identified: simple cystic appearance (20%) and mixed cystic-solid appearance (80%) with either a diffuse subsolid component (30%) or mural nodule(s) (50%). All lesions revealed exophytic location with a strong male predominance (9:1). MCNs occurred exclusively in middle-aged women, IPMN in both sexes showed slight male predominance (13:7), and SCN showed female predominance (5:15). Median patient age in LEC (48.5, IQR 47–54.5) was significantly younger compared to IPMN (p < 0.001) and SCN (p = 0.02). Unenhanced CT attenuation of LEC was higher than MCNs (p = 0.025) and IPMNs (p = 0.021), showing no significant difference to SCN (p = 0.343). Conclusion The present study provides key radiological features of LEC for the differentiation from other cystic pancreatic lesions such as increased CT attenuation in the unenhanced phase, absence of a connection to the main pancreatic duct (MPD), and exophytic location. In addition to these imaging features, clinical data, such as male predominance in LEC, must be considered for the differentiation of cystic pancreatic lesions.

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“…22,27 Establishing a differential diagnosis between LEC of the pancreas and other cystic neoplasms with malignant potential is difficult due to the elevation in serum tumor markers such as CA19-9, the internal protrusion of the cyst walls, 2 and wall calcification. 38 Fineneedle aspiration biopsy (FNAB) was performed in 8 patients during their operative course, 10,13,17,18,21,27,31,37 but LEC was diagnosed in only 2 (12.5%). Thus, FNAB may be an unsuitable technique for diagnosing pancreatic cystic tumors.…”

Section: Discussionmentioning

confidence: 99%

Lymphoepithelial Cyst of the Pancreas: Report of a Case

Tsuchiya¹,

Suzuki²,

Sakaguchi³

et al. 2000

Surgery Today

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An extremely rare case of a lymphoepithelial cyst (LEC) of the pancreas is described herein. A pancreatic cystic tumor was initially detected in a 50-year-old man at a medical checkup. On admission, his serum carbohydrate antigen (CA) 19-9 level was 8100 U/ml and a computed tomography scan revealed a well-circumscribed multilocular cystic tumor in the pancreatic head and body. Magnetic resonance cholangiopancreatography showed no communication between the pancreatic ducts and the tumor. A distal pancreatectomy with lymph node dissection was performed because the lesion was suspected to be a mucinous cystadenoma or cystadenocarcinoma of the pancreas. However, histological examination revealed that the cyst was lined by stratified squamous epithelium and surrounded by lymphoid tissue. thereby confirming the diagnosis of LEC of the pancreas. The superficial layer of squamous epithelium and the cystic contents were found to be immunohistologically positive for CA19-9. Establishing a preoperative diagnosis of LEC is quite difficult because it resembles other cystic neoplasms of the pancreas in radiographic features and is frequently associated with an elevation of serum tumor markers such as CA19-9.

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Lymphoepithelial cyst of the pancreas

Cited by 6 publications

References 14 publications

Lymphoepithelial Cyst of the Pancreas: Can Common Imaging Features Help to Avoid Resesction?

Lymphoepithelial Cyst of the Pancreas: Can Common Imaging Features Help to Avoid Resesction?

Lymphoepithelial cyst of the pancreas: can common imaging features help to avoid resection?

Lymphoepithelial Cyst of the Pancreas: Report of a Case

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