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Surgical Pathology Criteria
http://surgpathcriteria.stanford.edu/

Paraduodenal Wall Cyst

Definition

  • Postinflammatory cystic lesion periampullary region

Alternate/Historical Names

  • Cystic dystrophy
  • Groove pancreatitis
  • Myoadenomatosis
  • Pancreatic hamartoma of the duodenum

Diagnostic Criteria

  • Mucosal thickening
  • Trabeculation of duodenal muscularis
  • Intramural cysts
    • Lining may be pancreatic ductal epithelium or inflammation/granulation tissue
    • Walls composed of inflamed fibrous tissue
      • May have foreign body giant cell reaction
      • Frequent calcification
  • Located in or on duodenal wall
    • May involve adjacent pancreas
    • Typically in region of ampulla or accessory ducts
  • Microcystic trabeculation of duodenal wall has been termed myoadenomyomatosis

Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342

Original posting : February 28, 2008
Update: April 25, 2009

Supplemental studies

No diagnostically useful stains

Differential Diagnosis

  • Location effectively separates it from other cystic lesions

Clinical

  • Most in males
  • Most 40-50 years of age
  • Frequent history of alcohol abuse

Lists

Cystic Pancreatic Lesions

Bibliography

  • Adsay NV. Cystic lesions of the pancreas. Mod Pathol. 2007 Feb;20(Supp1):S71-S93).
  • Basturk O, Coban I, Adsay NV. Pancreatic cysts: pathologic classification, differential diagnosis, and clinical implications. Arch Pathol Lab Med. 2009 Mar;133(3):423-38.
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