Adsay N V, Hasteh F, Cheng J D, Klimstra D S
Department of Pathology, The Karmanos Cancer Institute-Detroit Medical Center, Wayne State University, MI 48076, USA.
Semin Diagn Pathol. 2000 Feb;17(1):56-65.
In the pancreas, 3 types of morphologically similar lesions may present as "squamous cysts": Lymphoepithelial cysts, dermoid cysts (monodermal teratomas), and epidermoid cysts in intrapancreatic accessory spleen. Lymphoepithelial cysts (LECs) are seen predominantly in men (M/F: 4/1) and in adulthood (mean age, 56, and range, 35 to 74 years). They may occur at any site of the organ (head, body, or tail). LECs are well-delineated cysts that may be multilocular (60%) or unilocular (40%), and they are characterized microscopically by stratified squamous epithelium surrounded by a band of mature lymphoid tissue with intervening well-formed germinal centers. Solid lymphoepithelial clusters are seldom seen. The pathogenesis of LECs is unclear; 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 LECs of the pancreas. The second type of squamous-lined cyst in the pancreas is the epidermoid cyst arising in intrapancreatic accessory spleen. These are located almost exclusively in the tail of the pancreas, in the fourth decade of life (mean age = 38). Their mean size is 4.5 cm (range, 2.3 to 6.5). In some cases, the cyst lining may be partly mucinous. Dermoid cysts of the pancreas are also rare. The cases that appear to be true dermoid cysts occur in a younger age group (mean age, 23, range, 2 to 53 years), and in contrast with LEC, there is no gender predominance. 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. The importance of these lesions is in their distinction from other cystic neoplasms, especially mucinous cystic tumors.
在胰腺中，3种形态相似的病变可能表现为“鳞状囊肿”：淋巴上皮囊肿、皮样囊肿（单胚层畸胎瘤）以及胰腺内副脾中的表皮样囊肿。淋巴上皮囊肿（LECs）主要见于男性（男/女：4/1），发病年龄多在成年期（平均年龄56岁，范围35至74岁）。它们可发生于胰腺的任何部位（头部、体部或尾部）。LECs是边界清晰的囊肿，可为多房性（60%）或单房性（40%），镜下特征为分层鳞状上皮，周围有一条成熟淋巴组织带，其间有发育良好的生发中心。很少见到实性淋巴上皮细胞团。LECs的发病机制尚不清楚；已知与唾液腺中类似病变相关的临床疾病，如干燥综合征或人类免疫缺陷病毒，在胰腺LECs中尚未有相关记录。胰腺中第二种有鳞状内衬的囊肿是胰腺内副脾中出现的表皮样囊肿。这些囊肿几乎都位于胰腺尾部，发病年龄在40岁左右（平均年龄 = 38岁）。它们的平均大小为4.5厘米（范围2.3至6.5厘米）。在某些情况下，囊肿内衬可能部分为黏液性。胰腺皮样囊肿也很罕见。真正的皮样囊肿病例发生在较年轻的年龄组（平均年龄23岁，范围2至53岁），与LEC不同的是，没有性别优势。皮样囊肿中更容易识别黏液上皮、呼吸型黏膜和皮脂腺单位，并且可能含有毛发。上皮下淋巴组织不是其特征。它们有时会并发化脓性感染。这些病变的重要性在于它们与其他囊性肿瘤，尤其是黏液性囊性肿瘤的鉴别。
