Serous cystadenoma of the pancreas

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Serous cystadenoma of the pancreas is a benign cystic lesion of the pancreas.

Serous cystadenoma of the pancreas
Diagnosis in short

Pancreatic serous cystadenoma. H&E stain.
Synonyms serous microcystic adenoma
LM small cystic spaces lined by cytologically bland cuboidal cells
LM DDx cystic renal cell carcinoma, lymphangioma, hemangioma
Stains PAS +ve, PASD -ve
Gross lobulated appearance, no cysts apparent
Site pancreas - body and tail
Syndromes von Hippel-Lindau disease
Prevalence uncommon
Radiology honey comb-like appearance, Well-demarcated border - may be described as a "coin lesion"
Prognosis benign

It is also known as serous microcystic adenoma,[1] and pancreatic serous cystadenoma.

It is unrelated to the ovarian serous cystadenoma.

General

  • 1-2% of all exocrine pancreatic tumours.
  • Female > male.
  • Mean age 66 years.
  • Truly benign with no malignant potenial.
  • May be part of von Hippel-Lindau syndrome.

Management:

  • Observe or resect.

Gross

Features:

  • Classically has a characteristic central scar.[2]
  • Bosulated surface.
  • Lobulated.
  • No (macroscopic) cysts apparent on gross.
  • Location: 50-70% occur in the body and tail.
  • Size: average size 11 cm.

Radiologic appearance:

  • Honey comb-like appearance.
  • Well demarcated border - may be described as a "coin lesion".

Image:

Microscopic

Features:

  • Cystic spaces lined by cuboidal cells.
    • Glycogen rich.
    • Cilia. (???)

DDx:

Notes:

  • Serous adenoma may coexist with aggressive tumours.

Images

  • PSC - low mag. (WC)

  • PSC - intermed. mag. (WC)

  • PSC - high mag. (WC)

  • PSC - very high mag. (WC)

Stains

  • PAS +ve.
  • PASD -ve.

See also

References

  1. ↑ Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Oberman, Harold A; Reuter, Victor E (2004). Sternberg's Diagnostic Surgical Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 1630. ISBN 978-0781740517.
  2. ↑ Kim YH, Saini S, Sahani D, Hahn PF, Mueller PR, Auh YH (2005). "Imaging diagnosis of cystic pancreatic lesions: pseudocyst versus nonpseudocyst". Radiographics 25 (3): 671–85. doi:10.1148/rg.253045104. PMID 15888617. http://radiographics.rsna.org/content/25/3/671.abstract.
  3. ↑ Vernadakis, S.; Kaiser, GM.; Christodoulou, E.; Mathe, Z.; Troullinakis, M.; Bankfalvi, A.; Paul, A. (2009). "Enormous serous microcystic adenoma of the pancreas.". JOP 10 (3): 332-4. PMID 19454830.
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