Lymphoepithelial Cyst of the Pancreas: A Rare Case Report and Review of Literature

Abstract

Lymphoepithelial cysts are rare pancreatic lesions of undetermined pathogenesis. The literature on this entity is limited to case reports or small series. We describe a case of 66 year male, incidentally diagnosed as lymphoepithelial cyst of pancreas that was managed by enucleation. This is the first case report of lymphoepithelial cyst from India. An extensive Medline search was carried out for lymphoepithelial cyst of pancreas. Till date less than 100 cases were identified in available literature. All these cases (including our case) were analyzed. This entity has uniform and distinctive clinicopathological features. About half of the reported cases were asymptomatic with most of the lesions diagnosed incidentally. Majority of patients presents with non-specific symptoms making preoperative diagnosis difficult. Lymphoepithelial cyst of the pancreas is a rare benign lesion, which is difficult to diagnose preoperatively. High index of suspicion and preoperative fine needle aspiration cytology may help in making diagnosis and avoiding surgery in asymptomatic patients.

Simultaneous Occurrence of a Rare Pancreatic Lymphoepithelial Cyst and Duodenal Mesenteric Castleman’s Disease: a Case Report

“…The histogenesis of LEC is unknown. A proposed mechanism of pathogenesis for LEC is the development from epithelial remnants in lymph nodes [1]. The histopathological appearance of LEC is characterized by cysts lined by stratified squamous epithelium, which is surrounded by the adjacent dense subepithelial lymphoid tissue with abundant lymphoid follicles [4] and also was demonstrated in our case.…”

“…Pancreatic lymphoepithelial cyst (LEC) is a rare pancreatic lesion of undetermined pathogenesis, which is a true pancreatic cyst lined by squamous epithelium and surrounded by mature lymphoid tissue [1]. Castleman's disease (CD) is a rare disorder that presents either as a localized disease or a systemic disease.…”

A Rare Presentation of Pancreatic Lymphoepithelial Cyst: A Case Report and Review

“…It is commonly an incidental finding, albeit patients may present with nonspecific symptoms such as abdominal pain and nausea [9,12,16,17]. Majority of the LECs are well-defined, round, anechoic, or hypoechoic complex cystic lesions with enhancing septa or rim, uniformly distributed in an exophytic location around the head, body, and tail of the pancreas [3,7,15,18,19]. However, these features can overlap with other types of pancreatic lesions such as intraductal papillary mucosal neoplasms or mucinous cystic neoplasms which have malignant potential, leading to unnecessary surgical intervention.…”

An Unusual Suspect: Lymphoepithelial Cyst of the Pancreas

“…Patients can also present with malaise, nausea, vomiting, anorexia, and back pain [1]. Weight loss can also be seen, thus, mimicking malignant pancreatic neoplasms [7]. …”