Abstract
Purpose
The purpose of the study was to investigate imaging features as well as pathologic and clinical findings of lymphoepithelial cyst (LEC) of pancreas.
Materials and methods
Ten patients with surgically resected and pathologically proven LEC, found in a single institution database between 2000 and 2015, were evaluated in a retrospective fashion. Patients’ demographics, clinical presentation, co-morbidities, imaging features, cytology and histopathology results, and serum/aspirate biomarkers levels were recorded.
Results
Eighty percent of patients were male with median age of 59. All lesions were exophytic, with median size of 36 mm. 80% were classified as complex cystic lesions, showing enhancing septa or enhancing rim without measurable enhancing solid component. 80% were located in tail or body. In one patient with MRI, the lesion was mildly T1 hyperintense and markedly T2 hyperintense. All cases were anechoic or hypoechoic on EUS, and majority of them showed posterior acoustic enhancement. Of patients with available fluid aspirate analysis, 3 out of 4 had CEA level > 192 ng/mL and 1 out of 3 had elevated (>250 IU/ml) amylase level. Four out of 7 patients had elevated serum CA 19-9 levels (>37 U/mL); one patient with a value of 361 U/mL had co-existing pancreatic adenocarcinoma.
Conclusion
Round shape, mild complexity, and exophytic location in pancreatic body and tail can be suggestive of LECs. These features however are not specific and may be seen with other cystic pancreatic lesions. CT findings should be used in conjunction with EUS, cytology, and tumor marker studies to secure the diagnosis of LEC.
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References
Truong LD, Rangdaeng S, Jordan PH Jr (1987) Lymphoepithelial cyst of the pancreas. Am J Surg Pathol 11(11):899–903
Luchtrath H, Schriefers KH (1985) A pancreatic cyst with features of a so-called branchiogenic cyst. Pathologe 6(4):217–219
Fukukura Y, et al. (1998) Lymphoepithelial cysts of the pancreas: demonstration of lipid component using CT and MRI. J Comput Assist Tomogr 22(2):311–313
Jian B, et al. (2008) Lymphoepithelial cysts of the pancreas: endosonography-guided fine needle aspiration. Diagn Cytopathol 36(9):662–665
Kavuturu S, et al. (2013) Lymphoepithelial cysts of the pancreas. can preoperative imaging distinguish this benign lesion from malignant or pre-malignant cystic pancreatic lesions? JOP 14(3):250–255
Kim WH, et al. (2013) Lymphoepithelial cyst of the pancreas: comparison of CT findings with other pancreatic cystic lesions. Abdom Imaging 38(2):324–330
Kim YH, et al. (1998) Lymphoepithelial cysts of the pancreas: CT and sonographic findings. Abdom Imaging 23(2):185–187
Martin J, et al. (2014) Lymphoepithelial cysts of the pancreas:a management dilemma. Hepatobiliary Pancreat Dis Int 13(5):539–544
Mege D, et al. (2014) Lymphoepithelial cyst of the pancreas: an analysis of 117 patients. Pancreas 43(7):987–995
Nasr J, et al. (2008) Lymphoepithelial cysts of the pancreas: an EUS case series. Gastrointest Endosc 68(1):170–173
Shinmura R, Gabata T, Matsui O (2006) Lymphoepithelial cyst of the pancreas: case report with special reference to imaging–pathologic correlation. Abdom Imaging 31(1):106–109
Terakawa H, et al. (2014) Clinical and radiological feature of lymphoepithelial cyst of the pancreas. World J Gastroenterol 20(45):17247–17253
Rockacy M, Khalid A (2013) Update on pancreatic cyst fluid analysis. Ann Gastroenterol 26(2):122–127
Adsay NV, et al. (2002) Lymphoepithelial cysts of the pancreas: a report of 12 cases and a review of the literature. Mod Pathol 15(5):492–501
Policarpio-Nicolas ML, et al. (2006) Fine-needle aspiration cytology of pancreatic lymphoepithelial cysts. Cancer 108(6):501–506
Domen H, et al. (2012) Lymphoepithelial cyst of the pancreas. Case Rep Gastroenterol 6(3):604–611
Kudo D, et al. (2011) Usefulness of in-phase and out-of-phase magnetic resonance imaging for the detection of pancreatic lymphoepithelial cyst. Hepatogastroenterology 58(109):1403–1405
Nam SJ, et al. (2010) Lymphoepithelial cysts in the pancreas: MRI of two cases with emphasis of diffusion-weighted imaging characteristics. J Magn Reson Imaging 32(3):692–696
Matrone A, et al. (2010) Lymphoepithelial pancreatic cyst: an atypical benign pancreatic mass presenting with a “cheerios-like” appearance. JOP 11(2):170–172
Gao W, et al. (2012) A case of lymphoepithelial cyst of pancreas with unique “cheerios-like” appearance in EUS. Clin J Gastroenterol 5(6):388–392
Mandavilli SR, Port J, Ali SZ (1999) Lymphoepithelial cyst (LEC) of the pancreas: cytomorphology and differential diagnosis on fine-needle aspiration (FNA). Diagn Cytopathol 20(6):371–374
Raval JS, et al. (2010) Pancreatic lymphoepithelial cysts express CEA and can contain mucous cells: potential pitfalls in the preoperative diagnosis. Mod Pathol 23(11):1467–1476
Yamaguchi T, et al. (2008) Lymphoepithelial cyst of the pancreas associated with elevated CA 19-9 levels. J Hepatobiliary Pancreat Surg 15(6):652–654
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Borhani, A.A., Fasanella, K.E., Iranpour, N. et al. Lymphoepithelial cyst of pancreas: spectrum of radiological findings with pathologic correlation. Abdom Radiol 42, 877–883 (2017). https://doi.org/10.1007/s00261-016-0932-3
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DOI: https://doi.org/10.1007/s00261-016-0932-3