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Macrocystic Serous Adenoma of the Pancreas: Radiologic—Pathologic Correlation

Bharti Khurana1, Koenraad J. Mortelé1, Jonathan Glickman2, Stuart G. Silverman1 and Pablo R. Ros1

1 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115.
2 Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.



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  		Fig. 1A. —36-year-old woman who presented with abdominal pain. Axial T1-weighted (TR/TE, 600/14) (A) and axial T2-weighted (5000/112) (B) spin-echo MR images show well-defined unilocular cystic lesion (arrows) in pancreatic head. Note that apparent interfaces seen in cystic lesion and gallbladder are artifactual.

 


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  		Fig. 1B. —36-year-old woman who presented with abdominal pain. Axial T1-weighted (TR/TE, 600/14) (A) and axial T2-weighted (5000/112) (B) spin-echo MR images show well-defined unilocular cystic lesion (arrows) in pancreatic head. Note that apparent interfaces seen in cystic lesion and gallbladder are artifactual.

 


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  		Fig. 1C. —36-year-old woman who presented with abdominal pain. Unenhanced (C) and gadolinium-enhanced (D) fat-suppressed T1-weighted spin-echo MR images (600/14) show no enhancement of lesion (arrows).

 


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  		Fig. 1D. —36-year-old woman who presented with abdominal pain. Unenhanced (C) and gadolinium-enhanced (D) fat-suppressed T1-weighted spin-echo MR images (600/14) show no enhancement of lesion (arrows).

 


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  		Fig. 1E. —36-year-old woman who presented with abdominal pain. Photograph of gross specimen of lesion shown in A—D reveals well-circumscribed, smooth-walled unilocular cyst (arrows) with adjacent normal-appearing pancreas.

 


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  		Fig. 2A. —78-year-old woman who presented with abdominal pain. Contrast-enhanced CT scan shows well-defined cystic lesion with single thin septation (arrow) in pancreatic tail.

 


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  		Fig. 2B. —78-year-old woman who presented with abdominal pain. Photograph of low-power microscopic view of lesion shows cyst wall has simple epithelial lining without papillary projections and thin fibrous wall, which are well demarcated from normal-appearing pancreatic parenchyma. (H and E, x40)

 


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  		Fig. 3A. —42-year-old woman who presented with abdominal pain. Contrast-enhanced CT scan shows 1.5 x 2.0 cm well-defined cystic lesion (arrow) in pancreatic neck.

 


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  		Fig. 3B. —42-year-old woman who presented with abdominal pain. Photograph of microscopic view of cyst wall shows cyst wall is composed of simple cuboidal epithelial lining and thin underlying fibrous cyst wall. (H and E, x200)

 


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  		Fig. 3C. —42-year-old woman who presented with abdominal pain. Photograph of high-power microscopic view of epithelial lining of lesion shows lining is composed of bland round nuclei and clear cytoplasm. (H and E, x400)

 

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