Normal cells

Normal cells Fine needle aspiration of normal pancreas yield a combination of benign acinar and ductal epithelial cells. Benign acinar epithelium – cytologic features Single cells or acini Eccentrically placed, round nuclei Evenly distributed, finely granular chromatin Incospicuous nucleoli Abundant granular cytoplasm Indistinct cell borders Benign ductal epithelium – cytologic features Flat, cohesive ‘honeycomb’ sheets […]

Pancreatic cysts

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, […]


Acute pancreatitis Acute pancreatitis results from the enzymatic autodestruction of the parenchyma and the accompanying acute inflammatory response. It is most commonly associated with biliary tract disease or alcoholism. The diagnosis rests on clinical findings and laboratory evidence, and the radiologic appearance is usually not suggestive of a mass lesion. For this reason, it is […]

Solid tumors

Solid tumors Ductal adenocarcinoma Acinar cell carcinoma Solid-pseudopapillary tumor Endocrine tumors Metastatic tumors

Cystic tumors

Cystic tumors Pancreatic cystic tumors account for about 5% of pancreatic neoplasms. They also include cystic dilatations of intraductal neoplasms, cystic degenerations of solid neoplasms (solid-pseudopapillary tumor), and solid neoplasms with focal cystic change (ductal adenocarcinoma with cystic degeneration, cystic acinar cell carcinoma, cystic pancreatic endocrine tumor). Serous cystadenoma It usually occurs in elderly women, […]

Pancreatic pseudocysts

Pancreatic pseudocysts Pancreatic pseudocysts occur in the setting of acute pancreatitis, resulting from autodigestion of the parenchyma. They account for the vast majority of pancreatic cystic lesions (75-90%). Pseudocysts can be rarely associated with trauma or pancreatic surgery. By definition, a pseudocyst lacks an epithelial lining. It is an unilocular thick-walled lesion, composed of an […]

Acinar cell carcinoma

Acinar cell carcinoma It is a rare, aggressive malignancy, usually arising in adults, but it has been reported in children and adolescents as well. Cytologic diagnostic features Groups of cells in nests, cords or acini Single cells Nuclear irregularity, crowding, overlapping Increased N/C ratio Conspicuous nucleoli Moderately abundant granular cytoplasm Absence of ductal epithelium The […]

Ductal adenocarcinoma

Ductal adenocarcinoma It is the most common pancreatic tumor (85-90%). It usually occurs in elderly patients and most commonly involve the head of the pancreas. It has been associated with smoking and recurrent pancreatitis and its prognosis is poor. Cytologic diagnostic features (moderately to poorly differentiated tumors) Increased cellularity Crowded sheets (with feathered edges) Single […]

Reporting terminology

Reporting terminology Diagnostic terminology for pancreatic FNA used empirically a five-tier system including the following categories: Negative for malignant cells Atypical cells present Suspicious cells present Positive for malignant cells Non-diagnostic specimen A negative diagnosis in the setting of a radiologically detected mass implies either a failure to sample the lesion or the presence of […]