Fine-needle aspiration cytology of pancreatic lymphoepithelial cysts.
BACKGROUND
Lymphoepithelial cysts (LECs) of the pancreas are extremely rare, benign, nonneoplastic cysts that can mimic pseudocysts or cystic neoplasms clinically and radiographically. The cytologic features of LECs have been described only in a handful of case reports and may overlap with both benign and malignant pancreatic tumors.


METHODS
The authors conducted a 5-year, retrospective, computerized review of the cytopathology files of 2 institutions for all diagnoses of pancreatic LECs. Clinical, radiographic, cytologic, and chemical findings were reviewed.


RESULTS
Four patients were identified. The study group consisted of 3 men and 1 woman who ranged in age from 33 years to 63 years. The masses were located throughout the pancreas. Tumor sizes ranged from 1.8 cm to 5.7 cm in greatest dimension. Smears from all patients revealed numerous anucleated squamous cells, rare benign nucleated cells, amorphous debris, and an absence of lymphocytes. Mildly atypical mucinous glandular and parakeratotic epithelium were identified in 2 patients, leading to diagnoses of atypical and suspicious for malignancy. Subsequent surgical follow-up of 3 patients revealed pancreatic LECs.


CONCLUSIONS
Pancreatic LECs are extremely rare, and certain cytologic pitfalls may hinder a correct prospective diagnosis. Familiarity with the lesion's clinical and cytologic features may help clinicians arrive at the appropriate prospective diagnosis and, thus, permit conservative management. Cancer
Policarpio-Nicolas
Maria Luisa
ML
Department of Pathology, University of Virginia, Charlottesville, VA 22908, USA.
Shami
Vanessa M
VM
Kahaleh
Michel
M
Adams
Reid B
RB
Mallery
Shawn
S
Stanley
Michael W
MW
Bardales
Ricardo H
RH
Stelow
Edward B
EB
D000328:Adult; D044963:Biopsy, Fine-Needle; D001707:Biopsy, Needle; D003584:Cytological Techniques; D019160:Endosonography; D005260:Female; D006801:Humans; D008210:Lymphocele / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis*; D010181:Pancreatic Cyst / Q000175:diagnosis*; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D010192:Pancreatic Pseudocyst / Q000175:diagnosis*; D012189:Retrospective Studies