Surgical Pathology Criteria

Mucinous Cystic Neoplasm of the Pancreas

Differential Diagnosis

Intraductal Papillary Mucinous Neoplasm Mucinous Cystic Neoplasm of the Pancreas
Usually over age 50 Usually under age 50
Male>female Nearly all female
Involves segments of ducts Does not communicate with ducts
Multiple adjacent cystic spaces If multilocular, usually many smaller cysts within a circumscribed larger cyst
Extensive papillae formation Minimal papillae
No ovarian type stroma Ovarian type stroma
May be associated with colloid carcinoma No association with colloid carcinoma

Mucinous Cystic Neoplasm of the Pancreas Intraductal Oncocytic Papillary Neoplasm
Lacks oncocytic epithelium Oncocytic epithelium
Lacks intracytoplasmic lumens and cribriform pattern Prominent cribriform pattern formed by intracytoplasmic lumens
Complex papillae not seen Complex arborizing papillae
Cellular ovarian type stroma Paucicellular stroma
No communication with ducts Communicates with duct system

Intraductal Tubular Adenoma Mucinous Cystic Neoplasm of the Pancreas
Nodular intraductal growth Mucin filled cyst or cysts
Low grade atypia Atypia may vary from low to high
Males and females affected Nearly all female
Involves segments of ducts Does not communicate with ducts
Extensive tubule formation No tubules
No ovarian type stroma Ovarian type stroma

Intraductal Tubular Carcinoma Mucinous Cystic Neoplasm of the Pancreas
Nodular intraductal growth Mucin filled cyst or cysts
Males and females affected Nearly all female
Involves segments of ducts Does not communicate with ducts
Extensive tubule formation No tubules
No ovarian type stroma Ovarian type stroma

Serous Macrocystic / Oligocystic Adenoma Mucinous Cystic Neoplasm of the Pancreas
Cuboidal clear epithelial lining Mucinous lining
Occurs in males and females Nearly all female
Lack ovarian type stroma Ovarian type stroma

Pancreatic Pseudocyst Mucinous Cystic Neoplasm of the Pancreas
Lack epithelial lining Epithelial lining (may be focal in degenerate cases)
Male>female Nearly all female
Lack ovarian type stroma Ovarian type stroma

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