Groot Vincent P, Thakker Sameer S, Gemenetzis Georgios, Noë Michaël, Javed Ammar A, Burkhart Richard A, Noveiry Behnoud B, Cameron John L, Weiss Matthew J, VandenBussche Christopher J, Fishman Elliot K, Hruban Ralph H, Wolfgang Christopher L, Lennon Anne Marie, He Jin
Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Surgery, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
HPB (Oxford). 2018 Jul;20(7):612-620. doi: 10.1016/j.hpb.2018.01.003. Epub 2018 Mar 9.
Lymphoepithelial cysts (LECs) are rare pancreatic cystic lesions. Since LECs are benign, preoperative diagnosis is important to differentiate from a cystic neoplasm and avoid unnecessary surgery. The aim of this study was to identify clinical, radiographic and cytopathologic features associated with LECs.
A retrospective review was performed of patients diagnosed with LEC between 1995 and 2017 at our hospital. Clinicopathologic and radiographic imaging features were documented.
Of 29 patients with pancreatic LEC, 22 underwent surgical resection. The majority were male (n = 24) with a median age of 55 years (range, 21-74). During the evaluation, all patients underwent a CT, with endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) biopsy (n = 22) and/or MRI/MRCP (n = 11) performed in a smaller number of patients. A combination of exophytic tumor growth on imaging and the presence of specific cytomorphologic features on the EUS-FNA cytology biopsy led to the correct diagnosis of LEC and prevention of unnecessary surgery in 7 patients.
Differentiating LECs from premalignant pancreatic cystic neoplasms remains difficult. Findings of an exophytic growth pattern of the lesion on abdominal imaging and the presence of specific cytomorphologic features in the EUS-FNA biopsy could help clinicians diagnose LEC preoperatively.
淋巴上皮囊肿（LECs）是罕见的胰腺囊性病变。由于LECs是良性的，术前诊断对于与囊性肿瘤相鉴别并避免不必要的手术很重要。本研究的目的是确定与LECs相关的临床、影像学和细胞病理学特征。
对1995年至2017年在我院诊断为LEC的患者进行回顾性研究。记录临床病理和影像学特征。
29例胰腺LEC患者中，22例接受了手术切除。大多数为男性（n = 24），中位年龄55岁（范围21 - 74岁）。在评估过程中，所有患者均接受了CT检查，少数患者进行了内镜超声（EUS）引导下细针穿刺（FNA）活检（n = 22）和/或磁共振成像/磁共振胰胆管造影（MRI/MRCP）（n = 11）。影像学上的外生性肿瘤生长与EUS - FNA细胞学活检中特定细胞形态学特征的结合，使得7例患者得以正确诊断LEC并避免了不必要的手术。
将LECs与胰腺癌前囊性肿瘤区分开来仍然很困难。腹部影像学上病变的外生性生长模式以及EUS - FNA活检中特定细胞形态学特征的发现，有助于临床医生术前诊断LEC。
