title: Macrocystic form of serous pancreatic cystadenoma.
abstract: OBJECTIVE
  Macrocystic serous cystadenoma of the pancreas are benign lesions with sometimes difficult diagnostic issues. We aimed to describe clinicopathological and imaging features with cyst fluid analysis in a series of patients undergoing surgery for macrocystic serous cystadenoma.
  
  
  METHODS
  Eight patients underwent pancreatic resection for a macrocystic lesion of the pancreas diagnosed on ultrasonography or CT. Endoscopic ultrasonography and preoperative fine-needle aspiration were performed in seven patients. Immunohistochemical analysis of the surgical specimen with antibodies to carcinoembryonic-antigen (CEA), carbohydrate antigen (CA) 19-9, estrogen receptor, and progesterone receptor antibodies was performed in all cases.
  
  
  RESULTS
  Patients included seven women and one man, with a mean age of 48 yr. Lesions were incidentally discovered on ultrasonography in six patients and had a mean size of 3 cm (range, 1.5-5 cm). Endoscopic ultrasonography revealed millimetric cysts in three cases. In the seven aspirated cysts, cytological analysis was non-contributive, but biochemical analysis showed low content of CEA (< 5 ng/ml) and CA72.4 (< 40U/ml) in all but two. At histology, cysts were lined by clear cuboidal cells. They focally expressed CA19-9 but were negative for anti-CEA, antiestrogen receptor, and antiprogesterone receptor antibodies. Microscopic cysts in the wall of the lesions were demonstrated in five cases.
  
  
  CONCLUSIONS
  Macrocystic serous cystadenoma is a particular variant of pancreatic serous cystadenoma. Endoscopic ultrasonography may be useful in detecting peripherally located millimetric cysts in unilocular lesions, and measurement of enzymes and tumor markers in cyst fluid may also contribute to the diagnosis showing low concentrations.
authors.affiliation: Service d'Anatomie Pathologique, Hĵpital Saint-Antoine, Assistance Publique-Hĵpitaux de Paris, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Chatelain
authors.forename: Pascal
authors.initials: P
authors.lastname: Hammel
authors.forename: Dermot
authors.initials: D
authors.lastname: O'Toole
authors.forename: Benoît
authors.initials: B
authors.lastname: Terris
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
authors.forename: Laurent
authors.initials: L
authors.lastname: Palazzo
authors.forename: Jacques
authors.initials: J
authors.lastname: Belghiti
authors.forename: Philippe
authors.initials: P
authors.lastname: Lévy
authors.forename: Philippe
authors.initials: P
authors.lastname: Ruszniewski
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Fléjou
mesh_terms: D000328:Adult; D000368:Aged; D020420:Cyst Fluid / Q000737:chemistry; D018293:Cystadenoma, Serous / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology; D003560:Cysts / Q000175:diagnosis / Q000473:pathology; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed