Summary:
Cytologic and histologic features in a case of serous microcystic adenoma of the pancreas in
a 61-year-old female are presented. In fine-needle aspiration materials, epithelial cells arranged
singly, in small clusters and in monolayer sheets were found. The neoplastic cells had round to
oval nuclei with finely distributed chromatin and inconspicuous nucleoli. Nuclear atypia and
mitoses were not seen. The cytoplasm was moderately abundant and finely granular.
Histologically, the encapsulated tumor was composed of multiple small cysts lined by a single
layer of flat to cuboidal cells. The tumor cells contained clear cytoplasm with glycogen and
centrally located round to oval nuclei with inconspicuous nucleoli without any atypia. Mitoses
were absent. The intervening stromal septa were hypocellular. Immunohistochemically, the tumor
cells revealed diffuse positivity of cytokeratins and epithelial membrane antigen. Proliferative
antigen Ki-67 was positive only in sporadic cells. No immunoreactivity for vimentin, carcinoembryonal
antigen and S-100 protein was found. Chromogranin A and synaptophysin were expressed
only in Langerhans’ islets in the tumor capsula.
In differential diagnosis, it is important to distinguish serous microcystic adenoma mainly from
lymphangioma, cavernous hemangioma, serous cystadenocarcinoma, mucinous cystadenoma or
cystadenocarcinoma, solid and pseudopapillary epithelial tumour, acinar cell cystadenocarcinoma,
renal cell carcinoma and mesothelioma.
Key words:
serous microcystic adenoma of the pancreas – cystic tumours – histology – fine-needle
aspiration cytology
|