A 62-year-old woman has an incidental 4 cm pancreatic body lesion described as a cluster of small cysts with a central stellate calcified scar ('sunburst' appearance) on CT. Cyst fluid analysis would most likely show low viscosity, low CEA and low amylase. The lesion is:

• A Mucinous cystic neoplasm
• B Intraductal papillary mucinous neoplasm
• C Serous cystadenoma ✓
• D Solid pseudopapillary neoplasm

Explanation

Serous cystadenoma is a benign microcystic lesion composed of glycogen-rich cuboidal cells, classically showing a central stellate scar with calcification in a 'sunburst' pattern, and it typically occurs in elderly women. Its fluid characteristically has low viscosity, very low CEA and low amylase because it does not communicate with the duct system. Mucinous cystic neoplasm and IPMN both produce thick mucinous fluid with high CEA, and solid pseudopapillary neoplasm occurs in young women and is largely solid with hemorrhagic degeneration.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.