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

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
Serous cystadenoma

 

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