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Pancreatic cysts

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Pancreatic cysts

The evaluation of pancreatic cysts requires a multidisciplinary approach. No single diagnostic test provides 100% sensitivity and specificity. The absence of cyst lining cells implies a pseudocyst in the appropriate clinical setting, but this is a diagnosis of exclusion. In the case of cysts the fluid is separately submitted for carcinoembryonic antigen (CEA), amylase, CA125 and CA19.9 testing.

Pitfalls of pancreatic cyst fluid cytology

  • Failure to sample epithelium (non-diagnostic sample)
  • Difficulty in categorizing epithelium as serous or mucinous
  • Failure to sample dysplastic/malignant epithelium
  • Contamination by gastrointestinal tract epithelium or mucin
  • Sampling of a non-pancreatic cyst