A 48-year-old woman undergoes CT for unrelated abdominal pain. The pancreas contains a 3 cm mass made of countless tiny cysts arranged around a central stellate scar with sunburst calcification. Cyst fluid shows low CEA and low amylase. What is the key biological feature of this lesion?
- A It is composed of glycogen-rich cuboidal cells and is almost always benign ✓
- B It secretes mucin and progresses to invasive carcinoma in about one third of cases
- C It arises from acinar cells and produces massive lipase elevation
- D It is defined by ovarian-type stroma and requires prophylactic resection
Correct answer: A. It is composed of glycogen-rich cuboidal cells and is almost always benign
Explanation
Microcystic serous cystadenoma shows innumerable small cysts lined by glycogen rich cuboidal cells draining into a central stellate scar that often calcifies, giving the classic sunburst pattern. It is essentially benign, so observation suffices unless symptoms develop. Mucinous cystic neoplasm has ovarian stroma and malignant potential, while branch duct IPMN communicates with the duct system and yields high CEA fluid. Acinar origin tumors present with lipase hypersecretion, not this morphology.
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.