Lymphoepithelial cysts of the pancreas

A report of 12 cases and a review of the literature

N. Volkan Adsay, Farnaz Hasteh, Jeanette D. Cheng, Pablo A. Bejarano, Gregory Y. Lauwers, Kenneth P. Batts, Günter Klöppel, David S. Klimstra

Research output: Contribution to journalArticle

119 Citations (Scopus)

Abstract

Lymphoepithelial cyst (LEC) of the pancreas is a rare lesion of undetermined pathogenesis that had been documented almost exclusively in males. The literature on this entity is limited to reports of single or small numbers of cases. Here is presented a clinicopathologic analysis of 12 patients with LEC, 4 of whom were female. The mean age of the patients was 56 years. Four patients presented with abdominal pain and nausea, but in two patients, the cysts were detected incidentally. Only one patient had a history of chronic pancreatitis, and another had a family member with pancreatic cancer. In one patient, a clinical diagnosis of pseudocyst was rendered, and the remaining patients were clinically thought to have cystic neoplasms. None of the patients had any identifiable immunosuppression, HIV positivity, autoimmune disorder (such as Sjogren syndrome) or lymphoma. Seven cysts were located in the head of the pancreas, and 5 were in the tail. The mean size was 4.8 cm (range, 1.2-17 cm). Five LECs were multilocular, three were unilocular; in others, the number of loculi was not recorded. All were "macrocystic" lesions. Two patients had two separate lesions, both in the tail of the pancreas. Histologically, all cases were characterized by cysts, some containing keratin, and lined by mature stratified squamous epithelium surrounded by dense lymphoid tissue, often with prominent follicles. In some areas, the lining epithelium had more cuboidal, flattened, or transitional appearance. Mucinous goblet-like cells were seen in one case. Acute inflammation was not seen. Four cases contained solid lymphoepithelial islands, a feature not previously described in LECs. No squamous metaplasia was identified in the uninvolved pancreatic tissue and no epithelial elements were identified in peripancreatic lymph nodes. In summary, LEC of the pancreas is a rare but distinctive lesion that may be seen in the tail of the organ where most cystic pancreatic neoplasms are encountered. In contrast to the impression from the literature, LECs may also develop in females and, therefore, should be considered in the clinical differential diagnosis of mucinous cystic neoplasms that affect a similar age group. LECs are not associated with the clinical syndromes that are seen with their analogues in the salivary glands.

Original languageEnglish
Pages (from-to)492-501
Number of pages10
JournalModern Pathology
Volume15
Issue number5
DOIs
StatePublished - May 27 2002

Fingerprint

Cysts
Pancreas
Epithelium
Pancreatic Neoplasms
Goblet Cells
Sjogren's Syndrome
Chronic Pancreatitis
Metaplasia
Lymphoid Tissue
Keratins
Salivary Glands
Islands
Immunosuppression
Nausea
Abdominal Pain
Lymphoma
Neoplasms
Differential Diagnosis
Age Groups
Lymph Nodes

Keywords

  • Cysts
  • Lymphoepithelial
  • Pancreas

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Adsay, N. V., Hasteh, F., Cheng, J. D., Bejarano, P. A., Lauwers, G. Y., Batts, K. P., ... Klimstra, D. S. (2002). Lymphoepithelial cysts of the pancreas: A report of 12 cases and a review of the literature. Modern Pathology, 15(5), 492-501. https://doi.org/10.1038/modpathol.3880553

Lymphoepithelial cysts of the pancreas : A report of 12 cases and a review of the literature. / Adsay, N. Volkan; Hasteh, Farnaz; Cheng, Jeanette D.; Bejarano, Pablo A.; Lauwers, Gregory Y.; Batts, Kenneth P.; Klöppel, Günter; Klimstra, David S.

In: Modern Pathology, Vol. 15, No. 5, 27.05.2002, p. 492-501.

Research output: Contribution to journalArticle

Adsay, NV, Hasteh, F, Cheng, JD, Bejarano, PA, Lauwers, GY, Batts, KP, Klöppel, G & Klimstra, DS 2002, 'Lymphoepithelial cysts of the pancreas: A report of 12 cases and a review of the literature', Modern Pathology, vol. 15, no. 5, pp. 492-501. https://doi.org/10.1038/modpathol.3880553
Adsay NV, Hasteh F, Cheng JD, Bejarano PA, Lauwers GY, Batts KP et al. Lymphoepithelial cysts of the pancreas: A report of 12 cases and a review of the literature. Modern Pathology. 2002 May 27;15(5):492-501. https://doi.org/10.1038/modpathol.3880553
Adsay, N. Volkan ; Hasteh, Farnaz ; Cheng, Jeanette D. ; Bejarano, Pablo A. ; Lauwers, Gregory Y. ; Batts, Kenneth P. ; Klöppel, Günter ; Klimstra, David S. / Lymphoepithelial cysts of the pancreas : A report of 12 cases and a review of the literature. In: Modern Pathology. 2002 ; Vol. 15, No. 5. pp. 492-501.
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