Serous Macrocystic / Oligocystic Adenoma of the Pancreas
Differential Diagnosis
- Serous microcystic adenoma
- Well differentiated neuroendocrine (islet cell) tumor
- Serous cystadenocarcinoma
- Mucinous cystic neoplasm
- Solid pseudopapillary neoplasm
- Acinar cystadenocarcinoma
- Lymphangioma
- Lymphoepithelial cyst
- Squamoid cyst of pancreatic ducts
- von Hippel Lindau syndrome
| Serous Macrocystic / Oligocystic Adenoma | Serous Microcystic Adenoma |
|---|---|
| Small number of larger, variably sized cysts | Innumerable small, uniform cysts |
| Lacks prominent scar | Frequent central scar |
| May occur in adults and infants | Not reported in infants |
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| Serous Macrocystic / Oligocystic Adenoma | Serous Cystadenocarcinoma of the Pancreas |
|---|---|
| Mass limited to pancreas, without vascular invasion | Requires vascular invasion, adjacent organ invasion or metastases |
| Serous Macrocystic / Oligocystic Adenoma | Mucinous Cystic Neoplasm of the Pancreas |
|---|---|
| Cuboidal clear epithelial lining | Mucinous lining |
| Occurs in males and females | Nearly all female |
| Lack ovarian type stroma | Ovarian type stroma |
| Serous Macrocystic / Oligocystic Adenoma | Solid Pseudopapillary Neoplasm of the Pancreas |
|---|---|
| True cysts lined by a single layer of cells | Variable thickness of lining of degenerate spaces |
| Occurs in males and females | Nearly all female |
| Glycogen positive | Glycogen negative |
| Keratin positive | Keratin variable |
| Serous Macrocystic / Oligocystic Adenoma | Acinar Cell Cystadenocarcinoma of the Pancreas |
|---|---|
| Lined by clear cells | Lined by cells with granular eosinophilic cytoplasm |
| PAS+, diastase sensitive | PAS+, diastase resistant |
| BCL10, trypsin, chymotrypsin negative | BCL10, trypsin, chymotrypsin positive |
| Serous Macrocystic / Oligocystic Adenoma | Lymphangioma |
|---|---|
| Lined by clear cells | Lined by endothelium |
| Keratin positive | CD31, CD34, D240 positive |
| Serous Macrocystic / Oligocystic Adenoma | Lymphoepithelial Cyst of the Pancreas |
|---|---|
| Lined by clear cells | Lined by squamous epithelium |
| Lacks lymphoid stroma | Prominent lymphoid stroma |
| Serous Macrocystic / Oligocystic Adenoma | Squamoid Cyst of Pancreatic Ducts |
|---|---|
| Lined by clear cells | Lined by squamoid cells |
| GLUT1 positive | GLUT1 at most focally positive |
von Hippel Lindau syndrome is associated with diffuse cystic transformation of the pancreas and occasionally with serous microcystic adenomas
