Table 1.
Typical characteristics | IPMN | MCN | SC | PSEUDO | SPN | LEC | cNET | cPDAC |
Age Group | Elderly | Middle | Middle-Elderly | Any | Young | Elderly | Middle-Elderly | Elderly |
Gender | 70% male | 95% female | > 50% female | > 50% male | 80%-90% female | 80% male | 50% each | > 50% male |
History | Asx; Pain; ± jaundice | Asx; Pain; nausea | Asx; VHL | Pancreatitis | Asx; Pain; nausea | Asx | Asx; Fxnl; MEN | Asx; Pain; ± jaundice |
Location in pancreas | Head in 70%; Multi-focal | Body/Tail in 95% | Anywhere | Anywhere | Anywhere | Peripheral | Anywhere | Anywhere |
Shape | Ovoid | Spheroid | Ovoid | Spheroid | Ovoid | Ovoid | Spheroid | Variable |
Locularity | Any | Uni or Oligo | Oligo or Multi | Uni | Oligo or Multi | Oligo | Uni | Any |
Duct Com-munication | Common | No | No | Common | No | No | No | Some |
Calcification | No | No | Central sunburst | No | Some | No | Some | No |
Cyst fluid appearance | Viscous, clear, muc | Viscous, clear, muc | Thin, clear, nonmuc | Opaque, bloody/necrotic debris | Opaque, bloody/necrotic debris | Nonmuc, crystalline debris | Nonmuc | Thin |
High CEA/Mucina | + | + | - | - | - | - | - | ± |
High Ca 19-9 | ± | ± | - | - | - | - | - | ± |
High amylase | + | - | - | + | - | - | - | ± |
Epithelium | Columnar, Papillary | Columnar | Cuboidal | No epithelium | Poorly cohesive cells with nuclear grooves | Squamoid | Uniform | Gland-forming |
Stroma | Fibrotic | Ovarian | Fibrotic | Fibrotic | Sometimes hyalinized | Lymphoid | Sometimes hyalinized | Fibrotic |
aMay be positive in cases of luminal contamination of endoscopic needle aspirate. IPMN: Intraductal papillary mucinous neoplasm; MCN: Mucinous cystic neoplasm; SC: Serous cystadenoma; PSEUDO: Pancreatic pseudocyst; SPN: Solid-pseudopapillary neoplasm; LE: Lymphoepithelial cyst; cNET: Cystic neuroendocrine tumor; cPDAC: Pancreatic ductal adenocarcinoma with cystic degeneration; VHL: Von hippel-lindau disease; Muc: Mucinous; Nonmuc: Nonmucinous; Asx: Asymptomatic; Fxnl: Functional. These data are derived generalizations of the literature, with the understanding that there is significant overlap among cyst types and there are inherent sampling errors associated with various tests; diagnostic and treatment decisions should not rely solely on the information presented in this review. An electronic worksheet version of this table is available at http://pathology.jhu.edu/pancreas/professionals/ipmn.php