Inspissated cyst fluid in endoscopic ultrasound-guided fine needle aspiration of pancreatic cysts

Diagnostic Cytopathology
Ivan ChebibMartha B Pitman

Abstract

Inspissated cyst fluid may be identified on pancreatic cyst aspiration cytology. We report on the cytomorphologic characteristics of inspissated cyst fluid on EUS-FNA of pancreatic cysts and correlate this finding with histopathology or multimodal (cytology, cyst fluid analysis, molecular pathology, imaging) classification of cyst type. The department archives were searched for pancreatic cyst fine-needle aspiration biopsies that contained dessicated, crystalline or inspissated material on cytologic preparations. Twenty-eight cases of pancreatic cysts containing inspissated material were identified. The cytomorphology of the inspissated material ranged from fibrillary fan-like structure (54%), ball-like structures (57%), and granular material (43%). When present, the fibrillary inspissated material was associated with neoplastic mucinous cysts in 11/15 (73%) cases, but was also seen in 2 pseudocysts, 1 serous cystadenoma, and 1 cyst of uncertain type (suggestive of mucinous cyst on EUS). The presence of fibrillary inspissated cyst material on cytology had a positive predictive value of 79% and a specificity of 63% for a neoplastic mucinous cyst. Although not highly specific, the presence of inspissated cyst fluid with fibrillar...Continue Reading

References

Apr 21, 2004·Cancer·Monica RecineSavitri Krishnamurthy
May 8, 2004·Gastroenterology·William R BruggeAndrew L Warshaw
Aug 31, 2010·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Jay S RavalAlyssa M Krasinskas
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Jan 1, 2014·Diagnostic Cytopathology·Christopher J VandenBussche, Zahra Maleki
May 24, 2014·Acta Cytologica·Oleksandr YergiyevJan F Silverman
Aug 9, 2015·Gastrointestinal Endoscopy·Martin JonesMartha B Pitman

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