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  • Surgical Pathology Criteria

    Lymphoepithelial Cyst of the Pancreas


    • Pancreatic cystic lesion lined by squamous epithelium with surrounding lymphoid stroma

    Diagnostic Criteria

    • Unilocular or multilocular lesion
      • Generally filled with keratinous debris
      • May protrude from pancreatic surface
    • Cysts lined by mature keratininzing squamous epithelium
      • Occasional cuboidal or transitional appearing areas
      • Rarely focal goblet or sebaceous cells
      • No skin adnexae
    • Uniform, dense surrounding lymphoid tissue
      • Frequently with germinal centers
      • May have peripheral space suggestive of subcapsular sinus
      • No acute inflammation
      • Occasional cases with lymphoepithelial-like lesions in surrounding lymphoid tissue
    • Surrounding pancreatic tissue normal or focally atrophic

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

    Original posting : 1/4/08
    Updates : 4/26/09, 11/18/12

    Supplemental studies


    No diagnostically useful markers


    Differential Diagnosis

    Most other cysts are easily distinguished by their non-squamous lining

    Lymphoepithelial Cyst of the Pancreas Dermoid Cyst
    No skin appendages or mesenchyme Skin appendages and mesenchyme common
    Sebaceous differentiation focal at most Sebaceous differentiation may be prominent

    Lymphoepithelial Cyst of the Pancreas Epidermoid Cyst in Intrapancreatic Accessory Spleen
    Surrounding dense lymphoid tissue Surrounding splenic red pulp

    Lymphoepithelial Cyst of the Pancreas Squamoid Cyst of Pancreatic Ducts
    Surrounding dense lymphoid tissue No surrounding lymphoid tissue
    Overt keratinization Non-keratinized
    Usually peripancreatic Intraductal

    Lymphoepithelial Cyst of the Pancreas Pancreatic Pseudocyst
    Squamous lining (may be partially denuded) No epithelial lining
    Uniform dense lymphoid stroma Variable surrounding inflammation


    • Predominantly reported in adults
      • Age range 3-82
    • M:F ratio 4:1
    • Not associated with HIV, autoimmune disorders or lymphoma
      • Only one reported case associated with HIV (Bedat)
    • Benign


    Cystic Pancreatic Lesions


    • Adsay NV, Hasteh F, Cheng JD, Bejarano PA, Lauwers GY, Batts KP, Kloppel G, Klimstra DS. Lymphoepithelial cysts of the pancreas: a report of 12 cases and a review of the literature. Mod Pathol. 2002 May;15(5):492-501.
    • 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
    • Bédat B, Genevay M, Dumonceau JM, Frossard JL, Forget J, Morel P, Berney T. Association between lymphoepithelial cysts of the pancreas and HIV infection. Pancreatology. 2012 Jan-Feb;12(1):61-4
    • England GM, Allen PW. Selected case from the Arkadi M. Rywlin International Pathology Slide Seminar: benign lymphoepithelial cyst, head of pancreas. Adv Anat Pathol. 2011 Jan;18(1):98-100
    • Raval JS, Zeh HJ, Moser AJ, Lee KK, Sanders MK, Navina S, Kuan SF, Krasinskas
      AM. Pancreatic lymphoepithelial cysts express CEA and can contain mucous cells: potential pitfalls in the preoperative diagnosis. Mod Pathol. 2010 Nov;23(11):1467-76
    Printed from Surgical Pathology Criteria: http://surgpathcriteria.stanford.edu/
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