Pancreatic Lymphoepithelial Cyst Showing Multiple Floating Ball-like Appearances

J Gastrointestin Liver Dis. 2016 Jun;25(2):239-42. doi: 10.15403/jgld.2014.1121.252.lym.

Abstract

A lymphoepithelial cyst (LEC) is a rare pancreatic lesion, histologically showing squamous epithelia, dense lymphoid tissues, and a keratin substance. Cross-section images of the pancreatic LEC typically show a well demarcated unilocular or multilocular cyst without a solid component. Here we report a rare case of pancreatic LEC in which multiple floating ball-like components were depicted via endoscopic ultrasound. The ball-like components were also depicted by various imaging methods such as computed tomography (CT) showing low-density components, T1-weighted magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) showing high-intensity components, and T2-weighted MRI showing low-intensity components. The ball-like components in all images were not well enhanced. Laparotomic cyst resection was performed, and the surgical material revealed keratin balls inside the pancreatic LEC. Keratin components of a pancreatic LEC can take a liquid, sludge, or solid form. Clinicians must be aware of the variations in imaging to facilitate the differentiation and management of pancreatic cystic lesions.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biopsy
  • Diffusion Magnetic Resonance Imaging
  • Endosonography
  • Humans
  • Keratins / analysis
  • Laparoscopy
  • Male
  • Multimodal Imaging / methods*
  • Pancreatic Cyst / chemistry
  • Pancreatic Cyst / diagnostic imaging*
  • Pancreatic Cyst / surgery
  • Predictive Value of Tests
  • Tomography, X-Ray Computed

Substances

  • Keratins