Microcystic Adenomas of the Pancreas (Glycogen-rich Cystadenomas): A Clinicopathologic Study of 34 Cases

Compagno, John; Oertel, James E.

doi:10.1093/ajcp/69.1.289

Cited by 485 publications

(208 citation statements)

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“…tel in the late 1970s (12,13) are now wellestablished entities. In the last two decades, intraductal neoplasms that present as cystic masses have received considerable attention in the literature (4,14,15).…”

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Lymphoepithelial Cysts of the Pancreas: a Report of 12 Cases and a Review of the Literature

et al. 2002

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Lymphoepithelial cyst (LEC) of the pancreas is a rare lesion of undetermined pathogenesis that had been documented almost exclusively in males. The literature on this entity is limited to reports of single or small numbers of cases. Here is presented a clinicopathologic analysis of 12 patients with LEC, 4 of whom were female. The mean age of the patients was 56 years. Four patients presented with abdominal pain and nausea, but in two patients, the cysts were detected incidentally. Only one patient had a history of chronic pancreatitis, and another had a family member with pancreatic cancer. In one patient, a clinical diagnosis of pseudocyst was rendered, and the remaining patients were clinically thought to have cystic neoplasms. None of the patients had any identifiable immunosuppression, HIV positivity, autoimmune disorder (such as Sjogren syndrome) or lymphoma. Seven cysts were located in the head of the pancreas, and 5 were in the tail. The mean size was 4.8 cm (range, 1.2-17 cm). Five LECs were multilocular, three were unilocular; in others, the number of loculi was not recorded. All were "macrocystic" lesions. Two patients had two separate lesions, both in the tail of the pancreas. Histologically, all cases were characterized by cysts, some containing keratin, and lined by mature stratified squamous epithelium surrounded by dense lymphoid tissue, often with prominent follicles. In some areas, the lining epithelium had more cuboidal, flattened, or transitional appearance. Mucinous goblet-like cells were seen in one case. Acute inflammation was not seen. Cystic lesions of the pancreas are relatively rare (1-3), but they constitute an important category with a challenging differential diagnosis at the clinical, radiological, and pathologic levels. In the past decade, wider application of radiographic techniques, coupled with the improvement in the surgical approach to this organ, has brought new attention to the cystic processes in the pancreas. As more cases of pancreatic cysts are being diagnosed and operated on, new clinicopathologic entities are being recognized (4 -6), and the old ones are becoming better characterized (7-10). Pseudocysts are the most common cystic lesions of the pancreas and usually occur as a complication of pancreatitis (11). True cysts, on the other hand, are most often neoplastic (1). The classification and understanding of these neoplastic pancreatic cysts have progressively improved in the last three decades. The serous and mucinous cystic neoplasms (SCN and MCN) described by Compagno and Oer-

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Lymphoepithelial Cysts of the Pancreas: a Report of 12 Cases and a Review of the Literature

et al. 2002

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“…In a series of 34 patients with MCA reported by Compagnio and Oertel, 4 patients died of causes related to their pancreatic tumor, 4 patients died intraoperatively, and 6 patients had complications resulting from surgery. 4 There are rare reports of malignant counterparts of MCA 27,28 as well as a patient with coexisting MCA and pancreatic ductal carcinoma. 29 Cystic neoplasms of the pancreas may be associated with von Hippel-Lindau disease, as was seen in one of the patients in this series.…”

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confidence: 99%

“…1 MCAs of the pancreas are relatively rare, most often benign neoplasms that usually occur in elderly patients and have no particular gender predilection. [2][3][4] MCAs are distributed evenly throughout the pancreas and most likely originate from the centroacinar cell. The most common clinical presentation is abdominal or epigastric discomfort, nausea, emesis, or weight loss caused by the large size of the mass.…”

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Microcystic adenoma of the pancreas

Lal

Bourtsos

DeFrias

et al. 2004

Cancer

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“…The mean age of the patients is 61 years. [126][127][128][129][130][131][132] Microscopically, these neoplasms have distinctive morphologic features. The cells lining the small cysts have clear cytoplasm, well-defined cytoplasmic borders, and small, round uniform nuclei with dense, homogeneous chromatin ( Figure 13).…”

Section: Serous Cystadenomamentioning

confidence: 99%

Cystic lesions of the pancreas

Adsay

2007

Modern Pathology

191

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Although cystic tumors of the pancreas are relatively rare, they constitute an increasingly important category. Advances in imaging and interventional techniques and the sharp drop in the mortality rate of pancreatic surgery have rendered pancreatic biopsies and resections commonplace specimens. Consequently, in the past two decades, the nature of many cystic tumors in this organ has been better characterized. The names of some existing entities were revised; for example, what was known as papillary-cystic tumor is now regarded as solidpseudopapillary tumor. New entities, in particular, intraductal papillary mucinous neoplasm and its variants, such as oncocytic and intestinal subtypes were recognized. The importance of clinical and pathologic correlation in the evaluation of these lesions was appreciated, in particular, with regards to the multifocality of these lesions, their association with invasive carcinomas, and thus their 'preinvasive' nature. Consensus criteria for the distinction of these from the ordinary precursors of adenocarcinoma, the pancreatic intraepithelial neoplasia, were established. The definition of mucinous cystic neoplasms was refined; ovarian-like stroma has now become almost a requirement for the diagnosis of mucinous cystic neoplasia, and defined as such, the propensity of these tumors to occur in perimenopausal women became even more striking. The validity and clinical value of classifying the pancreatic cysts of mucinous type as adenoma, borderline, CIS and invasive have been established. Related to this, the importance of thorough sampling in accurate classification of these mucinous lesions was recognized. Greater accessibility of the pancreas afforded by improved invasive as well as noninvasive modalities has also increased the detection of otherwise clinically silent cystic tumors, which has led to the recognition of more innocuous entities such as acinar cell cystadenoma and squamoid cyst of pancreatic ducts. As the significance of the cystic lesions emerged, cystic forms of otherwise typically solid tumors were also better characterized. Thus, significant developments have taken place in the classification and our understanding of pancreatic cystic tumors in the past few years, and experience with these lesions is likely to grow exponentially in the coming years. Modern Pathology (2007) 20, S71-S93.

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Microcystic Adenomas of the Pancreas (Glycogen-rich Cystadenomas): A Clinicopathologic Study of 34 Cases

Cited by 485 publications

References 0 publications

Lymphoepithelial Cysts of the Pancreas: a Report of 12 Cases and a Review of the Literature

Lymphoepithelial Cysts of the Pancreas: a Report of 12 Cases and a Review of the Literature

Microcystic adenoma of the pancreas

Cystic lesions of the pancreas

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