Fine needle aspiration cytomorphology of mucinous nonneoplastic cyst of the pancreas

Bing Zhu, Rajesh N Keswani, Xiaoqi Lin*

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

OBJECTIVES: Fine needle aspiration (FNA) cytomorphology of mucinous nonneoplastic cyst (MNNC) of the pancreas has not been described. METHODS: Nineteen of 24 patients with surgically diagnosed MNNCs had presurgery endoscopic ultrasound (EUS)-FNA biopsy. The FNA cytomorphology was retrospectively evaluated. Cyst fluid carcinoembryonic antigen and amylase concentrations were measured. RESULTS: Endoscopic US-FNA diagnoses ranged from unsatisfactory to suspicious for adenocarcinoma. Endoscopic US-FNA cytologic findings showed cuboidal or columnar cells arranged in flat 'honeycomb' sheets/nests (100.0%), papillary architecture (10.5%), acini formation (10.5%), 3-dimensional cluster (5.3%), abundant single cell pattern (5.3%), goblet cells (17.4%), and delicate or vacuolated (60.9%) cytoplasm variable in amount. Nuclei were round or oval and small to slightly enlarged with 1 or 2 inconspicuous nucleoli, fine granular chromatin, and smooth nuclear contour (irregular in 1 case). Nuclear grooves (43.5%) and nuclear pseudoinclusions (26.1%) were identified. Most cases showed thin mucin and thick mucin in 4 cases. Stroma was seen in 4 cases (17.4%). Degenerated cells/necrotic material and macrophages were also seen. Carcinoembryonic antigen ranged from 75.2 to 5,488 ng/ml and amylase from 19 to 28,478 U/L. CONCLUSIONS: Recognition of FNA cytomorphology of MNNC and valuable of carcinoembryonic antigen and amylase levels in cyst fluid is critical in clinical evaluation of pancreatic cysts.

Original languageEnglish (US)
Pages (from-to)27-31
Number of pages5
JournalPancreas
Volume42
Issue number1
DOIs
StatePublished - Jan 1 2013

Fingerprint

Fine Needle Biopsy
Cysts
Pancreas
Carcinoembryonic Antigen
Amylases
Cyst Fluid
Mucin-4
Pancreatic Cyst
Goblet Cells
Mucins
Chromatin
Cytoplasm
Adenocarcinoma
Macrophages

Keywords

  • Amylase
  • CEA
  • cytomorphology
  • fine needle aspiration
  • immunohistochemistry
  • mucinous nonneoplastic cyst

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

Cite this

@article{c293294ea8ac423398fdc18391199c4d,
title = "Fine needle aspiration cytomorphology of mucinous nonneoplastic cyst of the pancreas",
abstract = "OBJECTIVES: Fine needle aspiration (FNA) cytomorphology of mucinous nonneoplastic cyst (MNNC) of the pancreas has not been described. METHODS: Nineteen of 24 patients with surgically diagnosed MNNCs had presurgery endoscopic ultrasound (EUS)-FNA biopsy. The FNA cytomorphology was retrospectively evaluated. Cyst fluid carcinoembryonic antigen and amylase concentrations were measured. RESULTS: Endoscopic US-FNA diagnoses ranged from unsatisfactory to suspicious for adenocarcinoma. Endoscopic US-FNA cytologic findings showed cuboidal or columnar cells arranged in flat 'honeycomb' sheets/nests (100.0{\%}), papillary architecture (10.5{\%}), acini formation (10.5{\%}), 3-dimensional cluster (5.3{\%}), abundant single cell pattern (5.3{\%}), goblet cells (17.4{\%}), and delicate or vacuolated (60.9{\%}) cytoplasm variable in amount. Nuclei were round or oval and small to slightly enlarged with 1 or 2 inconspicuous nucleoli, fine granular chromatin, and smooth nuclear contour (irregular in 1 case). Nuclear grooves (43.5{\%}) and nuclear pseudoinclusions (26.1{\%}) were identified. Most cases showed thin mucin and thick mucin in 4 cases. Stroma was seen in 4 cases (17.4{\%}). Degenerated cells/necrotic material and macrophages were also seen. Carcinoembryonic antigen ranged from 75.2 to 5,488 ng/ml and amylase from 19 to 28,478 U/L. CONCLUSIONS: Recognition of FNA cytomorphology of MNNC and valuable of carcinoembryonic antigen and amylase levels in cyst fluid is critical in clinical evaluation of pancreatic cysts.",
keywords = "Amylase, CEA, cytomorphology, fine needle aspiration, immunohistochemistry, mucinous nonneoplastic cyst",
author = "Bing Zhu and Keswani, {Rajesh N} and Xiaoqi Lin",
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Fine needle aspiration cytomorphology of mucinous nonneoplastic cyst of the pancreas. / Zhu, Bing; Keswani, Rajesh N; Lin, Xiaoqi.

In: Pancreas, Vol. 42, No. 1, 01.01.2013, p. 27-31.

Research output: Contribution to journalArticle

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T1 - Fine needle aspiration cytomorphology of mucinous nonneoplastic cyst of the pancreas

AU - Zhu, Bing

AU - Keswani, Rajesh N

AU - Lin, Xiaoqi

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N2 - OBJECTIVES: Fine needle aspiration (FNA) cytomorphology of mucinous nonneoplastic cyst (MNNC) of the pancreas has not been described. METHODS: Nineteen of 24 patients with surgically diagnosed MNNCs had presurgery endoscopic ultrasound (EUS)-FNA biopsy. The FNA cytomorphology was retrospectively evaluated. Cyst fluid carcinoembryonic antigen and amylase concentrations were measured. RESULTS: Endoscopic US-FNA diagnoses ranged from unsatisfactory to suspicious for adenocarcinoma. Endoscopic US-FNA cytologic findings showed cuboidal or columnar cells arranged in flat 'honeycomb' sheets/nests (100.0%), papillary architecture (10.5%), acini formation (10.5%), 3-dimensional cluster (5.3%), abundant single cell pattern (5.3%), goblet cells (17.4%), and delicate or vacuolated (60.9%) cytoplasm variable in amount. Nuclei were round or oval and small to slightly enlarged with 1 or 2 inconspicuous nucleoli, fine granular chromatin, and smooth nuclear contour (irregular in 1 case). Nuclear grooves (43.5%) and nuclear pseudoinclusions (26.1%) were identified. Most cases showed thin mucin and thick mucin in 4 cases. Stroma was seen in 4 cases (17.4%). Degenerated cells/necrotic material and macrophages were also seen. Carcinoembryonic antigen ranged from 75.2 to 5,488 ng/ml and amylase from 19 to 28,478 U/L. CONCLUSIONS: Recognition of FNA cytomorphology of MNNC and valuable of carcinoembryonic antigen and amylase levels in cyst fluid is critical in clinical evaluation of pancreatic cysts.

AB - OBJECTIVES: Fine needle aspiration (FNA) cytomorphology of mucinous nonneoplastic cyst (MNNC) of the pancreas has not been described. METHODS: Nineteen of 24 patients with surgically diagnosed MNNCs had presurgery endoscopic ultrasound (EUS)-FNA biopsy. The FNA cytomorphology was retrospectively evaluated. Cyst fluid carcinoembryonic antigen and amylase concentrations were measured. RESULTS: Endoscopic US-FNA diagnoses ranged from unsatisfactory to suspicious for adenocarcinoma. Endoscopic US-FNA cytologic findings showed cuboidal or columnar cells arranged in flat 'honeycomb' sheets/nests (100.0%), papillary architecture (10.5%), acini formation (10.5%), 3-dimensional cluster (5.3%), abundant single cell pattern (5.3%), goblet cells (17.4%), and delicate or vacuolated (60.9%) cytoplasm variable in amount. Nuclei were round or oval and small to slightly enlarged with 1 or 2 inconspicuous nucleoli, fine granular chromatin, and smooth nuclear contour (irregular in 1 case). Nuclear grooves (43.5%) and nuclear pseudoinclusions (26.1%) were identified. Most cases showed thin mucin and thick mucin in 4 cases. Stroma was seen in 4 cases (17.4%). Degenerated cells/necrotic material and macrophages were also seen. Carcinoembryonic antigen ranged from 75.2 to 5,488 ng/ml and amylase from 19 to 28,478 U/L. CONCLUSIONS: Recognition of FNA cytomorphology of MNNC and valuable of carcinoembryonic antigen and amylase levels in cyst fluid is critical in clinical evaluation of pancreatic cysts.

KW - Amylase

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