Pancreatic Pathology Online

Pathology of Lymphoepithelial Cyst of the Pancreas

Dr Sampurna Roy MD            

 

Lymphoepithelial cyst is a rare, benign lesion first described in 1985 by Luchtrath and Schriefers. [A pancreatic cyst with features of a so-called branchiogenic cyst].  

This lesion should be taken into consideration when evaluating a cystic lesion of the pancreas because of different therapeutic approach in each case.

The pathogenesis of lymphoepithelial cysts is unclear.

Lymphoepithelial cysts are seen predominantly in men,  (Male/Female : 4/1) and in adults (mean age, 56, and range, 35 to 74 years). 

They may occur at any site of the organ (head, body, or tail).

Lymphoepithelial cysts are well-delineated cysts that may be multilocular (60%) or unilocular (40%).  The size of the lesion may range from 1 to more than 15 cms.

Microscopically, they are characterized by stratified squamous epithelium surrounded by a band of mature lymphoid tissue with intervening well-formed germinal centers.

In some areas, the lining epithelium display more cuboidal, flattened, or transitional appearance.

Mucinous goblet-like cells are seen in some cases.

Solid lymphoepithelial clusters are seldom seen.

Clinical diseases that are known to be associated with their counterparts in the salivary glands such as Sjogren disease or human immunodeficiency virus have not been documented for the lymphoepithelial cysts of the pancreas.

Cytological and histological analysis of fine needle aspiration material is of diagnostic interest and can avoid surgical resection when patients are symptom-free.

Differential diagnosis: 

- Epidermoid cyst of the pancreas - These are located almost exclusively in the tail of the pancreas, in the fourth decade of life.  In some cases, the cyst lining may be partly mucinous.

- Dermoid cysts of the pancreas -  Occur in a younger age group, in contrast with lymphoepithelial cyst , there is no gender predominance.Squamous-lined cysts of the pancreas: lymphoepithelial cysts, dermoid cysts (teratomas), and accessory-splenic epidermoid cysts.

Mucinous epithelium, respiratory-type mucosa and sebaceous units are more readily identifiable in dermoid cysts, and they may contain hair.

Subepithelial lymphoid tissue is not a feature.

They are sometimes complicated by suppurative infections.

- Mucinous Cystic Tumours of the Pancreas

- Serous Cystic Tumours of the Pancreas

 

Further reading:

Pancreatic cysts: pathologic classification, differential diagnosis, and clinical implications.

Lymphoepithelial cyst of the pancreas and elevated cyst fluid carcinoembryonic antigen: a diagnostic challenge.

Lymphoepithelial cysts of the pancreas:a management dilemma.

A case of lympho epithelial cyst of the pancreas.  

Cytologic features of lymphoepithelial cyst of the pancreas: two preoperatively diagnosed cases based on fine-needle aspiration.

Cyst fluid cytology and chemical features in a case of lymphoepithelial cyst of the pancreas: A rare and difficult preoperative diagnosis.

Lymphoepithelial cyst of the pancreas. No evidence for Epstein-Barr virus-related pathogenesis.

Lymphoepithelial cyst (LEC) of the pancreas: cytomorphology and differential diagnosis on fine-needle aspiration (FNA).

Cystic lymphoepithelial lesions of the pancreas and peripancreatic region: report of two cases.

Lymphoepithelial cyst of the pancreas: serum markers do not help.

Lymphoepithelial cyst of the pancreas. Report of a case diagnosed by fine needle aspiration biopsy.

 

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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