Pancreatic Lymphoepithelial Cyst Showing Multiple Floating Ball-like Appearances.
A lymphoepithelial cyst (LEC) is a rare pancreatic lesion, histologically showing squamous epithelia, dense lymphoid tissues, and a keratin substance. Cross-section images of the pancreatic LEC typically show a well demarcated unilocular or multilocular cyst without a solid component. Here we report a rare case of pancreatic LEC in which multiple floating ball-like components were depicted via endoscopic ultrasound. The ball-like components were also depicted by various imaging methods such as computed tomography (CT) showing low-density components, T1-weighted magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) showing high-intensity components, and T2-weighted MRI showing low-intensity components. The ball-like components in all images were not well enhanced. Laparotomic cyst resection was performed, and the surgical material revealed keratin balls inside the pancreatic LEC. Keratin components of a pancreatic LEC can take a liquid, sludge, or solid form. Clinicians must be aware of the variations in imaging to facilitate the differentiation and management of pancreatic cystic lesions.
Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi, Suntogun, Shizuoka, 411-8777, Japan. h.matsubayashi@scchr.jp.
Hiroyuki
H
Matsubayashi
Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Nagaizumi, Suntogun, Shizuoka, 411-8777, Japan.
Yoshiko
Y
Aikawa
Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Nagaizumi, Suntogun, Shizuoka, 411-8777, Japan.
Teiichi
T
Sugiura
Pathology, Shizuoka Cancer Center, Nagaizumi, Suntogun, Shizuoka, 411-8777, Japan.
Keiko
K
Sasaki
Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi, Suntogun, Shizuoka, 411-8777, Japan.
Kinichi
K
Hotta
Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi, Suntogun, Shizuoka, 411-8777, Japan.
Hiroyuki
H
Ono
D000368:Aged; D001706:Biopsy; D038524:Diffusion Magnetic Resonance Imaging; D019160:Endosonography; D006801:Humans; D007633:Keratins / Q000032:analysis; D010535:Laparoscopy; D008297:Male; D064847:Multimodal Imaging / Q000379:methods*; D010181:Pancreatic Cyst / Q000737:chemistry / Q000000981:diagnostic imaging* / Q000601:surgery; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed
D007633:Keratins