Unusual cystic epithelial choristoma in a celiac lymph node

Carr, Robert F.; Tang, Cheng Yong; Carrozza, Michael J.; Rodriguez, Ferdinand C.

doi:10.1016/s0046-8177(87)80064-3

Cited by 27 publications

(16 citation statements)

References 13 publications

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“…In fact, Arai et al (96) have identified what may be LEC precursors in the peripancreatic lymph nodes (19). Furthermore, there are also examples of LECs that occur in the intrabdominal lymph nodes (97,98). The puzzling aspects about this possibility are the following: (1) such epithelial remnants are detected exceedingly rarely (48), even more so than the LECs; (2) some LECs lack the characteristic features of a lymph node, such as sinuses and a capsule, and (3) although most LECs are predominantly peripancreatic, others appear to be situated within the organ itself, and unlike the parotid glands, intraglandular lymph nodes are exceedingly uncommon in the pancreas.…”

Section: Discussionmentioning

confidence: 99%

Lymphoepithelial Cysts of the Pancreas: a Report of 12 Cases and a Review of the Literature

et al. 2002

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Lymphoepithelial cyst (LEC) of the pancreas is a rare lesion of undetermined pathogenesis that had been documented almost exclusively in males. The literature on this entity is limited to reports of single or small numbers of cases. Here is presented a clinicopathologic analysis of 12 patients with LEC, 4 of whom were female. The mean age of the patients was 56 years. Four patients presented with abdominal pain and nausea, but in two patients, the cysts were detected incidentally. Only one patient had a history of chronic pancreatitis, and another had a family member with pancreatic cancer. In one patient, a clinical diagnosis of pseudocyst was rendered, and the remaining patients were clinically thought to have cystic neoplasms. None of the patients had any identifiable immunosuppression, HIV positivity, autoimmune disorder (such as Sjogren syndrome) or lymphoma. Seven cysts were located in the head of the pancreas, and 5 were in the tail. The mean size was 4.8 cm (range, 1.2-17 cm). Five LECs were multilocular, three were unilocular; in others, the number of loculi was not recorded. All were "macrocystic" lesions. Two patients had two separate lesions, both in the tail of the pancreas. Histologically, all cases were characterized by cysts, some containing keratin, and lined by mature stratified squamous epithelium surrounded by dense lymphoid tissue, often with prominent follicles. In some areas, the lining epithelium had more cuboidal, flattened, or transitional appearance. Mucinous goblet-like cells were seen in one case. Acute inflammation was not seen. Cystic lesions of the pancreas are relatively rare (1-3), but they constitute an important category with a challenging differential diagnosis at the clinical, radiological, and pathologic levels. In the past decade, wider application of radiographic techniques, coupled with the improvement in the surgical approach to this organ, has brought new attention to the cystic processes in the pancreas. As more cases of pancreatic cysts are being diagnosed and operated on, new clinicopathologic entities are being recognized (4 -6), and the old ones are becoming better characterized (7-10). Pseudocysts are the most common cystic lesions of the pancreas and usually occur as a complication of pancreatitis (11). True cysts, on the other hand, are most often neoplastic (1). The classification and understanding of these neoplastic pancreatic cysts have progressively improved in the last three decades. The serous and mucinous cystic neoplasms (SCN and MCN) described by Compagno and Oer-

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Section: Discussionmentioning

confidence: 99%

Lymphoepithelial Cysts of the Pancreas: a Report of 12 Cases and a Review of the Literature

et al. 2002

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“…Finally, pancreatic heterotopia has been observed in peripancreatic lymph nodes. 2,13 The interesting aspect of our case, besides the rarity of the findings, is that FNAB was used to diagnose the lesion. This diagnostic technique is proving to be increasingly useful for both deep-seated and superficial masses since it is extremely noninvasive and reliable and avoids surgery, which could be useless if not dangerous to the patient.…”

Section: Discussionmentioning

confidence: 92%

Lymphoepithelial Cyst of the Pancreas

Bolis

Farabi²,

Liberati³

et al. 1998

Acta Cytologica

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“…The last theory proposes that the cyst could occur by benign epithelial inclusion or ectopic pancreas in a peripancreatic lymph node. This theory is supported by the finding of a cystic epithelial choristoma contiguous to ectopic pancreatic tissue in a celiac lymph node [24]. …”

Section: Discussionmentioning

confidence: 98%

Lymphoepithelial Cyst in the Pancreas

et al. 2000

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Background: Lymphoepithelial cysts of the pancreas constitute a rare clinicopathologic entity. Case Report: We report a case of lymphoepithelial cyst of the pancreas and review the world literature. Results: Lymphoepithelial cysts are true pancreatic cysts lined by squamous epithelium and surrounded by mature lymphoid tissue. The cyst arises typically in middle aged men, and is usually asymptomatic or causes nonspecific abdominal complaints. There is no specific serologic marker for this entity. None of its radiologic characteristics can help differentiate it from other cystic lesions of the pancreas. Fine-needle aspiration cytology may be able to suggest its benign nature and identify it as a true cyst of the pancreas. The outcome after surgical excision is uniformly good with good symptom control and no recurrences. Recommendations: In the symptomatic patient or the asymptomatic patient with acceptable surgical risk a simple cyst excision should be performed after verification of the diagnosis with frozen section. In the asymptomatic patient with a high surgical risk, in whom fine-needle aspiration suggests the diagnosis of a lymphoepithelial cyst, observation of the lesion is recommended. When simple cyst excision is technically not possible, extensive resections/reconstructions should be avoided and drainage/bypass procedures may be considered.

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Unusual cystic epithelial choristoma in a celiac lymph node

Cited by 27 publications

References 13 publications

Lymphoepithelial Cysts of the Pancreas: a Report of 12 Cases and a Review of the Literature

Lymphoepithelial Cysts of the Pancreas: a Report of 12 Cases and a Review of the Literature

Lymphoepithelial Cyst of the Pancreas

Lymphoepithelial Cyst in the Pancreas

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