Pancreatic cystic lesions - morphology based classification of pancreatic cysts - Part 2

Classification of pancreatic cystic lesions based on morphology involves categorizing these lesions according to their appearance and structural characteristics. This classification can help in determining the potential malignancy or risk associated with the cystic lesion. Here's a general overview of common morphological classifications:
Serous Cystadenomas (SCAs):
These are typically benign cystic lesions.
Morphologically, they appear as macrocystic lesions with a honeycomb or sponge-like appearance on imaging.
They often have thin septations and lack internal solid components.
Mucinous Cystic Neoplasms (MCNs):
MCNs have the potential for malignancy.
Morphologically, they are characterized by the presence of thick, enhancing septations within the cyst, sometimes with nodules or mural nodules.
They may also demonstrate peripheral calcifications.
Intraductal Papillary Mucinous Neoplasms (IPMNs):
IPMNs can be benign or malignant.
They typically present as dilated pancreatic ducts containing mucin-secreting papillary projections.
Morphological characteristics include dilation of the main pancreatic duct and/or side branches, with or without associated cystic lesions.
Imaging may reveal a “duct-in-a-duct” or “cyst-in-a-cyst” appearance.
Solid Pseudopapillary Neoplasms (SPNs):
SPNs are typically low-grade malignant lesions.
Morphologically, they often present as well-encapsulated solid and cystic masses with hemorrhagic or necrotic areas.
Imaging may reveal cystic spaces within a solid tumor with central areas of calcification or hemorrhage.
Pancreatic Neuroendocrine Tumors (PanNETs):
These tumors can be functioning or non-functioning and may exhibit cystic degeneration.
Morphologically, they can present as well-defined cystic lesions with a solid enhancing component.
They may demonstrate characteristic hypervascular enhancement on imaging.
Lymphoepithelial Cysts:
These are typically benign cystic lesions.
Morphologically, they appear as unilocular or multilocular cysts with thin walls and lack internal septations or solid components.
They are often associated with chronic pancreatitis or autoimmune pancreatitis.
Cystic Pancreatic Metastases:
These cystic lesions result from metastases to the pancreas.
Morphologically, they may appear as multilocular cysts with irregular walls and septations, often with associated solid-enhancing components.
These are some common morphological classifications of pancreatic cystic lesions. However, it's important to note that accurate classification often requires a combination of imaging modalities (such as CT, MRI, or endoscopic ultrasound) and histopathological examination of tissue samples obtained via biopsy or surgical resection. Additionally, clinical and laboratory findings are essential for proper diagnosis and management.
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[@sirajkhoso8564]

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[@sirajkhoso8564]

Thanks sir. Your presentations are exceptionally easy to understand and helped me a lot in presentations and in delivering state of the art final year MBBS lectures. Regards