Non-gynaecological Cytology
Pancreatic and biliary cytology
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

Pancreatic pseudocysts

Pancreatic pseudocysts occur in the setting of acute pancreatitis, resulting from autodigestion of the parenchyma. They account for the vast majority of pancreatic cystic lesions (75-90%). Pseudocysts can be rarely associated with trauma or pancreatic surgery.

By definition, a pseudocyst lacks an epithelial lining. It is an unilocular thick-walled lesion, composed of an inflammatory fibrous capsule surrounding a region of necrosis. A communication with a pancreatic duct may be present. FNA yields abundant dark brown, turbid fluid and smears are composed of granular necrotic debris, blood, neutrophils and macrophages (also hemosiderin-laden macrophages). Aspirates may also contain pancreatic cells, fibroblasts and mesothelial cells. The diagnosis of pseudocyst on cytology should be considered one of exclusion.

  • Cyst debris with blood, proteinaceous material and sometimes bile
  • Variable inflammation
  • No cyst lining epithelium (beware of contamination, mucin and epithelium)
Pancreatic pseudocyst

Other non-neoplastic cysts

Other non-neoplastic cysts include retention cysts, cysts secondary to infections and congenital cysts; they are very rare and the diagnosis requires correlation with clinical findings.

 

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