Home   Chapter Home   Jobs   Conferences   Fellowships   Books



Advertisement

Pancreas

Cysts

Pseudocysts


Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 24 November 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

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 Oct 29;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
=========================================================================



Multiseptated lesion filled with fluid


Encapsulated cystic lesion with yellow-green material


Resembling cystic neoplasm

Micro 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

Micro images
=========================================================================



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


No epithelial lining is present


Cyst contains multiple lipid droplets (Sudan Black+) and cholesterol clefts


Pseudocyst of ectopic pancreas in duodenum

Differential diagnosis
=========================================================================

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

End of Pancreas > Cysts > Pseudocysts


This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).