Pancreas
Cysts
Pseudocysts

Author: Deepali Jain, M.D. (see Authors page)

Revised: 12 December 2017, last major update August 2012

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Pseudocysts[TI] pancreas[mh] full text[sb]

Cite this page: Jain, D. Pseudocysts. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/pancreaspseudocyst.html. Accessed December 16th, 2017.
Definition / general
  • Not a true cyst because no epithelial lining
  • Painful, localized collections of pancreatic secretions that develop after pancreatitis (acute or chronic), trauma, ductal calculi, obstructive neoplasms
  • Complications: abscess, erosion into blood vessels and hemorrhage of splenic artery, infection (J Med Case Rep 2007;1:116), perforation into a hollow viscus
Treatment
  • Excise small pseudocysts in body / tail, drain pseudocysts in head
Gross description
  • 85% solitary, usually unilocular, in / near pancreas
  • Thick, irregular wall, ragged inner surface, cloudy intraluminal contents
Gross images

Images hosted on other servers:

Multiseptated lesion filled with fluid

Encapsulated cystic lesion with yellow green material

Resembling cystic neoplasm

Microscopic (histologic) description
  • No epithelial lining, cyst arises from drainage of pancreatic secretions from damaged ducts into interstitial tissue, which becomes walled off by fibrous tissue
  • Cyst wall contains histiocytes, giant cells, granulation tissue, rarely eosinophils
  • Cyst may communicate with ductal system
  • Fluid has high amylase content
Microscopic (histologic) images

Images hosted on PathOut server:

Patient with chronic pancreatitis and pseudocyst; cyst lacks epithelial lining, wall contains dense collagen, chronic inflammatory cells and fat



Images hosted on other servers:

No epithelial lining is present

Multiple lipid
droplets (Sudan
black+) and
cholesterol clefts

Pseudocyst of ectopic pancreas in duodenum

Differential diagnosis
  • Pancreatic neoplasm, particularly if multiloculated
  • Serous cystadenoma with subtotal cystic degeneration: has glycogen rich epithelial lining and prominent subepithelial capillaries (Am J Surg Pathol 2012;36:726)
  • Sterile abscess with liquefactive necrosis