Pancreas
Cystic and intraductal lesions
True cysts
Author: Deepali Jain, M.D.
Last author update: 1 August 2012
Last staff update: 28 July 2023
Copyright: 2002-2024, PathologyOutlines.com, Inc.
PubMed Search: True cyst[TIAB] pancreas
Table of Contents
Congenital / dysgenetic cysts | Cysts of cystic fibrosis | Dermoid cysts | Epidermoid cysts | Foregut cysts attached to pancreas | Mesothelial cysts | Pancreatic hamartoma | Nonepithelial cysts | Pancreatic tissue derived cysts | Tumors that are cysticCite this page: Jain D. True cysts. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/pancreastrue.html. Accessed December 3rd, 2024.
Congenital / dysgenetic cysts
Definition / general
Case reports
Microscopic (histologic) images
AFIP images
- By definition are intrapancreatic, do not communicate with duct system, lined by a single layer of cuboidal, columnar or flattened atrophic epithelium with a fibrous wall
- Most congenital pancreatic cysts are multiple, almost all are associated with underlying congenital diseases that primarily affect other organ systems (AJR Am J Roentgenol 2002;179:1375)
- Often associated with polycystic disease affecting kidney and liver, von Hippel-Lindau syndrome or oral-facial-digital syndrome type I (GeneReviews: Oral-Facial-Digital Syndrome Type I [Accessed 11 December 2017])
- Single cysts may be due to abnormal duct development
- Other syndromes: Elejalde syndrome (eMedicine: Elejalde Syndrome [Accessed 11 December 2017]), glutaric aciduria II (NIH: Glutaric Acidemia Type II [Accessed 11 December 2017]), Ivemark syndrome (NORD: Ivemark Syndrome [Accessed 11 December 2017]), Jeune syndrome (NIH: Jeune Syndrome [Accessed 11 December 2017]), Meckel-Gruber syndrome (eMedicine: Meckel-Gruber Syndrome [Accessed 11 December 2017]), short rib polydactyly syndrome type 1 (OMIM: Short Rib Thoracic Dysplasia 3 With or Without Polydactyly [Accessed 11 December 2017]), trisomy 13, 14, 15, tuberous sclerosis
Case reports
- Multilocular cysts associated with choledochal cyst (Hum Pathol 2003;34:99)
Microscopic (histologic) images
AFIP images
Congenital cyst
Cysts of cystic fibrosis
Dermoid cysts
Definition / general
Case reports
Gross images
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Microscopic (histologic) images
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- Seen in young patients (2nd - 3rd decade)
Case reports
- 64 year old man (World J Surg Oncol 2007;5:85)
Gross images
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Tail of pancreas cyst
Microscopic (histologic) images
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Tail of pancreas cyst
Epidermoid cysts
Definition / general
Case reports
- May be present within an intrapancreatic spleen (Pancreas 2011;40:956)
- In tail, unilocular, typically contain concentric enzymatic concretions, may communicate with acinar system
- Squamoid cyst of pancreatic ducts; has thin wall lined by transitional / squamous cells without keratinization or granular layer
Case reports
- 62 year old man with intrapancreatic spleen containing epidermoid cyst (JOP 2011;12:279)
Foregut cysts attached to pancreas
Definition / general
Case reports
Microscopic (histologic) images
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Cytology images
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- Rare; unilocular, smooth surface with clear mucoid material, ciliated epithelium resembles bronchogenic cyst but no respiratory glands, no cartilage and two smooth muscle layers (Am J Surg Pathol 1996;20:476)
Case reports
- 34 year old woman with pancreatic mass (JSLS 2008;12:183)
- 37 year old woman with acute cholangitis (JOP 2011;12:420)
Microscopic (histologic) images
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Foregut cyst attached to pancreas
Cytology images
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Ciliated foregut cyst: FNA
Mesothelial cysts
Definition / general
Case reports
- May be multiple and involve pancreas, liver, kidney or other abdominal structures
Case reports
- 36 year old man with 3 cm cyst (Ann Diagn Pathol 2006;10:371)
Pancreatic hamartoma
Case reports
Microscopic (histologic) images
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- Initial report in 20 month old girl with 9 cm cystic mass (Hum Pathol 1992;23:1309)
- 52 year old woman with 2.5 cm mass in pancreatic head (J Korean Surg Soc 2012;83:330)
- Well demarcated and composed of cystic ductal structures embedded in focally inflamed stromal tissue (Am J Surg Pathol 2005;29:797)
Microscopic (histologic) images
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Various images
Nonepithelial cysts
Definition / general
- Includes endometrial cyst, lymphangioma, pseudocysts, parasitic cyst
Pancreatic tissue derived cysts
Definition / general
Gross images
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Microscopic (histologic) images
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- May appear in thorax or mediastinum, as components of gastroenteric duplication cysts, intralobar pulmonary sequestrations, teratomas or rarely from ectopic pancreatic tissue (Mod Pathol 1996;9:210)
- Paraduodenal wall cyst (cystic dystrophy): patients with paraduodenal (groove) pancreatitis, cysts may enlarge and adhere to duodenal wall, mimicking duodenal duplication; lined by granulation tissue, may be partly lined by ductal epithelium (Semin Diagn Pathol 2004;21:247)
Gross images
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Ectopic pancreas with cystic change in mediastinum
Microscopic (histologic) images
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Ectopic pancreas with cystic change in mediastinum
Tumors that are cystic
Definition / general
- Cystic tumors include ductal adenocarcinoma, IOPN, IPMN, lymphoepithelial cyst, mucinous cystic neoplasm, mucinous nonneoplastic cyst, serous cystadenoma, solid papillary neoplasm
