NEEDLE ASPIRATION CYTOLOGY OF PANCREATIC CYSTIC LESIONS

Forty-two histologically confirmed cases of pancreatic cystic lesions with cytologic evaluation by needle aspiration biopsy (NAB) were revie wed. There were 21 inflammatory pseudocysts (IPC), nine mucinous cysti c neoplasms (MCN), six microcystic serous adenomas (MSA), one macrocys tic serous adenoma, and Jive papillary solid and cystic neoplasms (PSC N). Correct cytodiagnosis was made in all cases of IPC and MCN. The co ntents of IPCs were characterized by turbid or blood-ringed fluid cont aining cellular debris, numerous foamy macrophages, and other inflamma tory cells. There were few or no epithelial lining cells. The aspirate s from MCNs showed gelatinous mucoid material containing mucus-secreti ng cells that were present singly, in clusters, or in sheers. Dependin g on the individual case, benign or malignant columnar cells, or an ad mixture of these cells, were present in a mucinous background The preo perative needle aspirates of five MSAs were acellular In one case of M SA and in one example of macrocystic serous adenoma, small monolayered sheets of benign cubic epithelial cells were seen in the needle aspir ates. Similar cytologic findings were noted in the materials obtained by intraoperative NAB performed under direct vision of the aforementio ned Jive MSAs. Difficulties were encountered in typing three PSCNs tha t yielded in NAB cells resembling those of an islet cell tumor They we re diagnosed as low-grade neoplasms (PSCN vs. islet cell tumor). In tw o other patients, a cytodiagnosis of PSCN was correctly made as the NA B revealed monomorphic tumor cells wrapping around small capillary blo od vessels. (C) 1997 Wiley-Liss, Inc.