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Pancreatic cystic lesions without overt cytologic atypia: proposed diagnostic categories for endoscopic ultrasound-guided fine-needle aspiration cytology with utilization of fluid carcinoembryonic antigen level.
Acta Cytol. 2012; 56(1):34-40.AC

Abstract

OBJECTIVES

It was the aim of this study to examine pancreatic cyst cases that lack markedly atypical or malignant epithelium on endoscopic ultrasound-guided fine-needle aspirations.

STUDY DESIGN

We conducted a retrospective case review study, including 24 cases that were either acellular or lacked cytologic atypia and were subsequently resected. The cases were retrospectively divided into 3 categories: (1) non-diagnostic, (2) cyst contents only, and (3) cyst contents with bland-appearing epithelium. The cyst contents were subdivided into mucinous and non-mucinous types. The cytologic diagnoses were correlated with cyst fluid carcinoembryonic antigen (CEA) levels and subsequent histologic diagnoses.

RESULTS

Category 1 comprised 4 cases: 2 cases (CEA >800 ng/ml) with mucin-producing neoplasms and 2 cases (CEA not determined) with microcystic serous cystadenomas. Category 2 included 4 cases with non-mucinous and 4 with mucinous contents. In the first subgroup, 2 cases (CEA >800 ng/ml) showed mucinous cystic neoplasms and 2 cases (CEA negligible or not determined) pseudocysts. In the second subgroup, there were 3 cases with neoplastic mucinous cysts (1 CEA >800 ng/ml, 2 not determined) and 1 case with a lymphoepithelial cyst with mucinous metaplasia (CEA >800 ng/ml). Almost all cases (10/11) in category 3 had neoplastic mucinous cysts regardless of the CEA levels.

CONCLUSIONS

The proposed 3 cytologic categories of pancreatic cystic lesion combined with cyst fluid CEA levels provide useful clinical information.

Authors+Show Affiliations

Department of Pathology, University of Kansas Medical Center, Kansas City, KS 66160, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22236743

Citation

Madan, Rashna, et al. "Pancreatic Cystic Lesions Without Overt Cytologic Atypia: Proposed Diagnostic Categories for Endoscopic Ultrasound-guided Fine-needle Aspiration Cytology With Utilization of Fluid Carcinoembryonic Antigen Level." Acta Cytologica, vol. 56, no. 1, 2012, pp. 34-40.
Madan R, Khan E, Cuka N, et al. Pancreatic cystic lesions without overt cytologic atypia: proposed diagnostic categories for endoscopic ultrasound-guided fine-needle aspiration cytology with utilization of fluid carcinoembryonic antigen level. Acta Cytol. 2012;56(1):34-40.
Madan, R., Khan, E., Cuka, N., Olyaee, M., Tawfik, O., & Fan, F. (2012). Pancreatic cystic lesions without overt cytologic atypia: proposed diagnostic categories for endoscopic ultrasound-guided fine-needle aspiration cytology with utilization of fluid carcinoembryonic antigen level. Acta Cytologica, 56(1), 34-40. https://doi.org/10.1159/000332972
Madan R, et al. Pancreatic Cystic Lesions Without Overt Cytologic Atypia: Proposed Diagnostic Categories for Endoscopic Ultrasound-guided Fine-needle Aspiration Cytology With Utilization of Fluid Carcinoembryonic Antigen Level. Acta Cytol. 2012;56(1):34-40. PubMed PMID: 22236743.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pancreatic cystic lesions without overt cytologic atypia: proposed diagnostic categories for endoscopic ultrasound-guided fine-needle aspiration cytology with utilization of fluid carcinoembryonic antigen level. AU - Madan,Rashna, AU - Khan,Emma, AU - Cuka,Nathan, AU - Olyaee,Mojtaba, AU - Tawfik,Ossama, AU - Fan,Fang, Y1 - 2012/01/04/ PY - 2011/08/17/received PY - 2011/09/08/accepted PY - 2012/1/13/entrez PY - 2012/1/13/pubmed PY - 2012/3/28/medline SP - 34 EP - 40 JF - Acta cytologica JO - Acta Cytol VL - 56 IS - 1 N2 - OBJECTIVES: It was the aim of this study to examine pancreatic cyst cases that lack markedly atypical or malignant epithelium on endoscopic ultrasound-guided fine-needle aspirations. STUDY DESIGN: We conducted a retrospective case review study, including 24 cases that were either acellular or lacked cytologic atypia and were subsequently resected. The cases were retrospectively divided into 3 categories: (1) non-diagnostic, (2) cyst contents only, and (3) cyst contents with bland-appearing epithelium. The cyst contents were subdivided into mucinous and non-mucinous types. The cytologic diagnoses were correlated with cyst fluid carcinoembryonic antigen (CEA) levels and subsequent histologic diagnoses. RESULTS: Category 1 comprised 4 cases: 2 cases (CEA >800 ng/ml) with mucin-producing neoplasms and 2 cases (CEA not determined) with microcystic serous cystadenomas. Category 2 included 4 cases with non-mucinous and 4 with mucinous contents. In the first subgroup, 2 cases (CEA >800 ng/ml) showed mucinous cystic neoplasms and 2 cases (CEA negligible or not determined) pseudocysts. In the second subgroup, there were 3 cases with neoplastic mucinous cysts (1 CEA >800 ng/ml, 2 not determined) and 1 case with a lymphoepithelial cyst with mucinous metaplasia (CEA >800 ng/ml). Almost all cases (10/11) in category 3 had neoplastic mucinous cysts regardless of the CEA levels. CONCLUSIONS: The proposed 3 cytologic categories of pancreatic cystic lesion combined with cyst fluid CEA levels provide useful clinical information. SN - 0001-5547 UR - https://www.unboundmedicine.com/medline/citation/22236743/Pancreatic_cystic_lesions_without_overt_cytologic_atypia:_proposed_diagnostic_categories_for_endoscopic_ultrasound_guided_fine_needle_aspiration_cytology_with_utilization_of_fluid_carcinoembryonic_antigen_level_ L2 - https://www.karger.com?DOI=10.1159/000332972 DB - PRIME DP - Unbound Medicine ER -