1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea 2Department of Surgery, Seoul National University College of Medicine, Seoul, Korea 3Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
Corresponding author:
Ji Kon Ryu,
ABSTRACT
The majority of pancreatic cystic lesions are benign pseudocysts, but 10-15% are ultimately proven to be cystic neoplasms. Serous cystadenoma and mucinous cystic neoplasm are the most common cystic neoplasms of the pancreas. Serous cystadenoma is benign and has a characteristic spongy gross appearance as a result of numerous microcysts. The individual cysts are lined by flat to cuboidal, clear to pale epithelial cells rich in glycogen. Mucinous cystic neoplasm has a potential to malignancy and consists of large macrocysts. Histologically, mucinous cystic neoplasms are lined with columnar epithelia containing intracellular mucin. In this report, we describe a rare type of cystic neoplasm of the pancreas arising in a 77-year-old woman who complained of a palpable abdominal mass. A distal pancreatectomy and splenectomy were done. The tumor was found to be a mixed pattem of macrocyst and microcyst and measured 7 x 5 x 3 cm. The lining cells were mainly composed of columnar cells which were positive for mucicarmine staining, but cuboidal cells which suggested serous cystadenoma were also noticed in some areas. The cuboidal cells were negative for mucicarmine but PAS stains did not disappear with diastase. Neither cellular atypism nor dysplasia were found. To the best of our knowledge, this is the first case ever reported of a variant type of mucinous cystic neoplasm which is grossly mixed macrocystic and microcystic and consists of two kinds of epithelial cells, one columnar and the other cuboidal.
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