Fine-needle aspiration of intrapancreatic accessory spleen: Cytomorphologic features and differential diagnosis

被引:30
|
作者
Tatsas, Armanda D. [1 ]
Owens, Christopher L. [2 ]
Siddiqui, Momin T. [3 ]
Hruban, Ralph H. [1 ]
Ali, Syed Z. [1 ,4 ]
机构
[1] Johns Hopkins Univ Hosp, Dept Pathol, Sol Goldman Pancreat Canc Res Ctr, Baltimore, MD 21287 USA
[2] Univ Massachusetts, Dept Pathol, Worcester, MA 01605 USA
[3] Emory Univ, Sch Med, Dept Pathol & Lab Med, Atlanta, GA 30322 USA
[4] Johns Hopkins Univ Hosp, Dept Radiol, Sol Goldman Pancreat Canc Res Ctr, Baltimore, MD 21287 USA
关键词
intrapancreatic accessory spleen; fine-needle aspiration; endoscopic ultrasound; pancreas; epidermoid cyst; EPIDERMOID CYST; ENDOCRINE TUMOR; PANCREAS; MIMICKING;
D O I
10.1002/cncy.21185
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND: Intrapancreatic accessory spleen (IPAS) is a rare benign lesion of the pancreas that frequently clinically and radiographically mimics a solid neoplasm. Very rarely, epidermoid cysts may form in IPAS and be mistaken for a cystic neoplasm of the pancreas on radiographic imaging. IPAS and epidermoid cyst involving intrapancreatic cyst (ECIPAS) are benign, and, if recognized, do not require surgical intervention. There are few reports of the cytopathologic features of IPAS diagnosed by fine-needle aspiration (FNA). METHODS: Here we report a series of 6 cases of endoscopic ultrasound (EUS)-guided FNA of IPAS, 3 of which had histological confirmation, including 1 case of histologically confirmed ECIPAS. RESULTS: Cytomorphologic features of IPAS include a polymorphous population of hematopoietic cells, including lymphocytes, eosinophils, histiocytes, plasma cells, and red blood cells, admixed with numerous small blood vessels representing splenic sinusoids. CD8 immunostaining of cell block or core biopsy material highlights splenic endothelial cells and confirms the diagnosis. FNA of ECIPAS reveals predominantly macrophages and proteinaceous debris. CONCLUSIONS: Diagnostic pitfalls include pancreatic neuroendocrine tumor. If IPAS is recognized as a diagnostic consideration on EUS-FNA, unnecessary surgical resection may be avoided. Cancer (Cancer Cytopathol) 2012. (c) 2012 American Cancer Society.
引用
收藏
页码:261 / 268
页数:8
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