A 60-year-old woman undergoes CT for unrelated complaints. The pancreas contains a 3 cm cystic lesion composed of innumerable tiny cysts less than 2 mm each arranged in a cluster around central septa, with a central stellate scar showing punctate calcification. No communication with the main pancreatic duct is seen. The most likely diagnosis is:

• A Mucinous cystic neoplasm
• B Serous cystadenoma ✓
• C Solid pseudopapillary neoplasm
• D Side branch intraductal papillary mucinous neoplasm

Explanation

Serous cystadenoma shows a honeycomb or sponge pattern of multiple microcysts under 2 cm, often with a central fibrous scar containing stellate or sunburst calcification, and it has no communication with the pancreatic duct. Mucinous cystic neoplasm has few larger locules with ovarian-type stroma and occurs almost exclusively in women, while side branch IPMN communicates with the ductal system. Serous cystadenoma is essentially benign and requires surveillance only.

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.