Lymphoepithelial Pancreatic Cyst: An Atypical Benign Pancreatic Mass Presenting with a 'Cheerios-Like' Appearance
Context Lymphoepithelial cyst of the pancreas is a rare benign lesion which often presents as an incidental radiological finding, but may cause symptoms, such as abdominal pain and nausea. It can occur at any location in the pancreas. The differential diagnosis includes primary splenic cysts, pseudocysts, mucinous cystic neoplasms of the pancreas, left adrenal cysts, duplication cysts and retroperitoneal cysts. Some of these diagnoses can be excluded by MRI; however, for the final diagnosis, fine needle aspiration or surgical resection may be necessary. Case report We report a rare case of a pancreatic lymphoepithelial cyst in an asymptomatic 63-year-old man, discovered in a clinical follow-up for colon cancer. In particular, we describe the unique "cheerios-like" appearance of the lesion which has never before been reported. Conclusion This particular finding could help in the differential diagnosis of this benign lesion from other pancreatic masses.
Image: T2-weighted axial MR image showing a complex mass consisting of multiple sub-centimeter nodules, with a "cheerios-like" appearance.
Truong LD, Rangdaeng S, Jordan PH Jr. Lymphoepithelial cyst of the pancreas. Am J Surg Pathol 1987; 11:899-903. [PMID 3674287] (FULL TEXT: http://journals.lww.com/ajsp/toc/1987/11000)
Frezza EE, Wachtel MS. Lymphoepithelial cyst of the pancreas tail. Case report and review of the literature. JOP. J Pancreas (Online) 2008; 9:46-9. [PMID 18182743] (FULL TEXT: http://www.joplink.net/prev/200801/09.html)
Adsay NV, Hasteh F, Cheng JD, Bejarano PA, Lauwers GY, Batts KP, et al. Lymphoepithelial cysts of the pancreas: a report of 12 cases and a review of the literature. Mod Pathol 2002; 15:492-501. [PMID 12011254] (FULL TEXT: http://www.nature.com/modpathol/journal/v15/n5/full/3880553a.html)
Neymann EG, Georgiades CS, Horton KH, Lillemoe KD, Fishman EK. Lymphoepithelial cyst of the pancreas--evaluation with multidetector CT. Clin Imaging 2005; 29:345-7. [PMID 16153542] (FULL TEXT: http://www.clinicalimaging.org/article/PIIS0899707105000021/fulltext)
Kim YH, Auh YH, Kim KW, Lee MG, Kim KS, Park SY. Lymphoepithelial cysts of the pancreas: CT and sonographic findings. Abdom Imaging 1998; 23:185-7. [PMID 9516512] (FULL TEXT: http://www.springerlink.com/content/ttylptnfr74eagt9/)
Koga H, Takayasu K, Mukai K, Muramatsu Y, Mizuguchi Y, Furukawa H, et al. CT of lymphoepithelial cysts of the pancreas. J Comput Assist Tomogr 1995; 19:221-4. [PMID 7890845] (FULL TEXT: http://journals.lww.com/jcat/toc/1995/03000)
Sako S, Isozaki H, Hara H, Tsutsumi A, Tanigawa N. Cystic lymphoepithelial lesions of the pancreas and peripancreatic region: report of two cases. Surg Today 1999; 29:467-71. [PMID 10333422] (FULL TEXT: http://www.springerlink.com/content/h516575322jn7191/fulltext.pdf)
Strapko A, Botash RJ, Murthy UK, Landas SK. Lymphoepithelial cyst of the pancreas: a case report and review of the literature. Dig Dis Sci 1998; 43:870-4. [PMID 9558046] (FULL TEXT: http://www.springerlink.com/content/q640n58452502026/)
Tsuchiya Y, Suzuki S, Sakaguchi T, Kojima Y, Okamoto K, Kurachi K, et al. Lymphoepithelial cyst of the pancreas: report of a case. Surg Today 2000; 30:856-60. [PMID 11039720] (FULL TEXT: http://www.springerlink.com/content/av8vkdc0w5w0u7fx/fulltext.pdf)
Tateyama H, Tada T, Murase T, Fujitake S, Eimoto T. Lymphoepithelial cyst and epidermoid cyst of the accessory spleen in the pancreas. Mod Pathol 1998; 11:1171-7. [PMID 9872647]
Ueno S, Muranaka T, Maekawa S, Masuda Y, Ro T, Saku M, Oshiumi Y. Radiographic features in lymphoepitelial cyst of the pancreas. Abdom Imaging 1994; 19:232-4. [PMID 8019350] (FULL TEXT: http://www.springerlink.com/content/jk04532v4013750q/fulltext.html)
Jacobs JE, Dinsmore BJ. Mature cystic teratoma of the pancreas: sonographic and CT findings. AJR Am J Roentgenol 1993; 160:523-4. [PMID 8430545] (FULL TEXT: http://www.ajronline.org/cgi/reprint/160/3/523)
Maekawa H, Yoneyama H, Komatsu Y, Orita H, Sakurada M, Sato K, Yamano M. Pancreatic lymphoepithelial cyst with an intracystic papillary projection. Report of a case. JOP. J Pancreas (Online) 2009; 10:694-6. [PMID 19890197] (FULL TEXT: http://www.joplink.net/prev/200911/17.html)
Copyright (c) 2010 Alessia Matrone, Maria Russo, Carmine Mollica, Domenico Lombardi, Guido Lombardi, Simone Maurea, Massimo Imbriaco
This work is licensed under a Creative Commons Attribution 4.0 International License.As a member of Publisher International Linking Association, PILA, iMedPub Group’s JOP follows the Creative Commons Attribution License and Scholars Open Access publishing policies. Journal of the Pancreas is the Council Contributor Member of Council of Science Editors (CSE) and following the CSE slogan Education, Ethics, and Evidence for Editors.