Table 2.
Key question | Likely diagnoses to consider | |
Demographics and history | Male? | MCN unlikely |
No history of pancreatitis? | PSEUDO unlikely | |
Young female? | SPN | |
History of MEN? | cNET | |
History VHL? | SC | |
Imaging | Spheroid? | PSEUDO or MCN |
Central sunburst calcification? | SC | |
Location in head? | MCN unlikely | |
Cyst fluid | No CEA/mucin? | IPMN or MCN unlikely |
High CEA, high amylase? | IPMN | |
High CEA, low amylase | MCN | |
Low CEA, high amylase? | PSUEDO | |
High amylase? | IPMN or PSEUDO | |
Histology | Epithelial lining? | PSEUDO unlikely |
Ovarian stroma? | MCN |
IPMN: Intraductal papillary mucinous neoplasm; MCN: Mucinous cystic neoplasm; SC: Serous cystadenoma; PSEUDO: Pancreatic pseudocyst; SPN: Solid-pseudopapillary neoplasm; VHL: Von hippel-lindau disease; MEN: Multiple endocrine neoplasia. 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