Serous Oligocystic Adenoma of the Pancreas

Differential Diagnosis

Serous Macrocystic / Oligocystic Adenoma	Serous Microcystic Adenoma
Small number of larger, variably sized cysts	Innumerable small, uniform cysts
Lacks prominent scar	Frequent central scar
May occur in adults and infants	Not reported in infants

Serous Macrocystic / Oligocystic Adenoma	Serous Cystadenocarcinoma of the Pancreas
Mass limited to pancreas, without vascular invasion	Requires vascular invasion, adjacent organ invasion or metastases

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

Serous Macrocystic / Oligocystic Adenoma	Solid Pseudopapillary Neoplasm of the Pancreas
True cysts lined by a single layer of cells	Variable thickness of lining of degenerate spaces
Occurs in males and females	Nearly all female
Glycogen positive	Glycogen negative
Keratin positive	Keratin variable

Clear cell variant of solid pseudopapillary neoplasm is also reported to be glycogen negative

Serous Macrocystic / Oligocystic Adenoma	Acinar Cell Cystadenocarcinoma of the Pancreas
Lined by clear cells	Lined by cells with granular eosinophilic cytoplasm
PAS+, diastase sensitive	PAS+, diastase resistant
BCL10, trypsin, chymotrypsin negative	BCL10, trypsin, chymotrypsin positive

Serous Macrocystic / Oligocystic Adenoma	Well Differentiated Pancreatic Neuroendocrine (Islet Cell) Tumor
Synaptophysin and chromogranin negative	Synaptophysin and chromogranin positive

Islet cell tumors may occasionally have clear cytoplasm

Serous Macrocystic / Oligocystic Adenoma	Lymphangioma
Lined by clear cells	Lined by endothelium
Keratin positive	CD31, CD34, D240 positive

Serous Macrocystic / Oligocystic Adenoma	Lymphoepithelial Cyst of the Pancreas
Lined by clear cells	Lined by squamous epithelium
Lacks lymphoid stroma	Prominent lymphoid stroma

Serous Macrocystic / Oligocystic Adenoma	Squamoid Cyst of Pancreatic Ducts
Lined by clear cells	Lined by squamoid cells
GLUT1 positive	GLUT1 at most focally positive

von Hippel Lindau syndrome is associated with diffuse cystic transformation of the pancreas and occasionally with serous microcystic adenomas