| Anatomy and histology of the pancreas |
| Fine needle aspiration (FNA) and other sampling methods |
| Reporting terminology |
| Normal cells |
| Pancreatitis |
| Pancreatic cysts |
| Solid tumors |
| Biliary tract cytology |
Serous cystadenoma
It usually occurs in elderly women, most often in the body and tail of the pancreas. It is usually benign, although rare cases of serous cystadenocarcinoma have been reported. Star-burst calcifications within a central scar can be diagnostic on imaging when present. Most tumors are 'microcystic' with multiple, <2cm cysts, but can be unilocular due to specific variant or due to haemorrhagic degeneration, causing problems with imaging diagnosis.
Cytologic preparations are characterized by low cellularity and the cells are arranged in small clusters or flat sheets. The cytoplasm is clear or vacuolated and the nuclei are small and round. The presence of glicogen is demonstrated by PAS positivity.
Cytologic diagnostic features
- Watery, non-mucinous fluid
- Scanty cellularity
- Clean, proteinaceous or bloody background
- Monolayered sheets or small, flat clusters
- Bland, uniform, round nuclei
- Scanty but visible non-mucinous cytoplasm
Differential diagnosis
- Benign ductal or acinar epithelium
- Lymphangioma/hemangioma
- Mucinous cystic neoplasm
- Cystic pancreatic endocrine tumor
- Metastatic renal cell carcinoma
