Korean J Hepatobiliary Pancreat Surg.  2015 Aug;19(3):129-132. 10.14701/kjhbps.2015.19.3.129.

Lymphoepithelial cyst of the pancreas mimicking malignant cystic tumor: report of a case

• Ryu DH
• Sung RH
• Kang MH
• Choi JW

• KMID: 2043290
• DOI: http://doi.org/10.14701/kjhbps.2015.19.3.129

Abstract

Lymphoepithelial cysts of the pancreas are a type of true cyst that can mimic pseudocysts and cystic neoplasms. They are very rare, non-malignant lesions that are unilocular or multilocular cystic lesions lined predominantly by mature squamous epithelium and surrounded by non-neoplastic lymphoid elements. We, herein, present a patient with a cystic pancreas tumor mimicking a malignant cystic neoplasm. The patient was admitted with upper abdominal discomfort. Computed tomography showed a 64x39 mm cystic mass in the pancreas tail. She underwent distal pancreatectomy and splenectomy. In the fluid analysis of the pancreas cystic mass, the CEA and CA19-9 were 618 ng/ml and 3.9 U/ml, respectively. The resected pancreas specimen showed a 6.5 cm-sized cyst the pancreas tail. The cyst was well circumscribed and multilocular. The final pathology report of the resected pancreas specimen noted that the cyst was multilocular, and the cyst lining was showing stratified squamous epithelium covering the lymphoid tissue (containing lymphoid follicles), which was consistent with a lymphoepithelial cyst. The patient recovered uneventfully from surgery and has been doing well for the past 3 months. A differential diagnosis of cystic pancreatic lesions is important. We suggest that lymphoepithelial cysts, although very rare, may be included in the differential diagnosis of cystic pancreatic tumors.

Keyword

Lymphoepithelial cysts; Cystic neoplasms; Pancreas

MeSH Terms

Diagnosis, Differential
Epithelium
Humans
Lymphoid Tissue
Pancreas*
Pancreatectomy
Pathology
Splenectomy
Tail

Figure

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  Fig. 1 Preoperative computed tomography images: Axial (A) and coronal (B) contrast-enhanced images show a large cystic mass with internal septa in the tail of the pancreas.

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  Fig. 2 The transaxial FDG PET-CT image shows no abnormal FDG tracer uptake at the pancreatic cystic mass.

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  Fig. 3 A photograph of the gross specimen shows a 6.5 cm-sized lymphoepithelial cyst of the pancreas tail. The cyst is well circumscribed and multilocular.

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  Fig. 4 A low-power view filed of the lymphoepithelial cyst. The cyst is multilocular, and the normal pancreatic parenchyma is seen in the lower left corner (H&E, ×40).

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  Fig. 5 A high-power view filed of the cyst-lining shows stratified squamous epithelium covering lymphoid tissue containing a lymphoid follicle (H&E, ×200).

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