Cystic and intraductal lesions


Topic Completed: 1 August 2012

Minor changes: 23 October 2020

Copyright: 2002-2021,, Inc.

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

Deepali Jain, M.D.
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Page views in 2021 to date: 4,816
Cite this page: Jain D. Pseudocysts. website. Accessed October 28th, 2021.
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
  • 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

AFIP images

Patient with
chronic pancreatitis
and pseudocyst

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
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