University of Texas Health Sciences Center Tyler, TX
Muhammad Almas, MD1, Omer Chowdhury, DO2, Muhammad Baig, MD3 1University of Texas Health Sciences Center, Tyler, TX; 2University of Texas Health Science Center, Tyler, TX; 3UT Health Science Center, Tyler, TX
Introduction: Lymphoepithelial cysts (LECs) of the pancreas are rare, true pancreatic cysts. Their pathogenesis is unclear and much of the literature is limited to case reports and series. Interestingly, these reports are almost exclusively documented in males. We present a case of an asymptomatic female patient who had an incidental finding of a pancreatic tail cyst with pathology confirmation of lymphoepithelial cyst.
Case Description/Methods: A 61-year-old female without significant past medical history was seen by her primary care physician for subacute cough. Initial workup with Chest Xray was unremarkable. Given continued symptoms refractory to medication treatment, she presented to an urgent care and underwent a computed tomography scan of chest and abdomen which showed an incidental 2.2 cm cystic mass in the tail of the pancreas. Tumor markers including CA 125, CEA, and CA 19-9 were obtained and were 5.4 U/mL, < 1.8 NG/mL, and < 9 U/mL, respectively. She was referred to our department for an Endoscopic Ultrasound (EUS). EUS demonstrated a well circumscribed 22 mm x 16 mm hypoechoic lesion with smooth borders in the pancreatic tail. Fine Needle Biopsy was performed, and histology showed small epithelial cysts without cytologic atypia surrounded by lymphoid cells consistent with lymphoepithelial cyst of the pancreas.
Discussion: LECs are extremely rare, true pancreatic cysts. To this date, there are less than 100 cases reported in the literature. LEC are predominantly reported in middle-aged men and most common presenting symptom is abdominal pain. Our patient’s pancreatic cyst was found incidentally, her gender and asymptomatic nature is unique. LECs are benign but surgical intervention can be considered in patients with continued symptoms, usually from mass effect. Given our patient’s asymptomatic status, shared decision was made not to perform any further surveillance or surgical intervention.
Figure: (Image 1): CT Pancreas showing cystic mass in the tail of the pancreas. (Image 2): EUS showing well circumscribed 22mm x 16mm hypoechoic lesion (Image 3): Keratinizing squamous epithelium with dense collection of lymphoid tissue
Disclosures:
Muhammad Almas indicated no relevant financial relationships.
Omer Chowdhury indicated no relevant financial relationships.
Muhammad Baig indicated no relevant financial relationships.
Muhammad Almas, MD1, Omer Chowdhury, DO2, Muhammad Baig, MD3. P3541 - Lymphoepithelial Pancreatic Cyst: A Rare Entity Among Pancreatic Cystic Lesions in Female Population, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
