Lymphoepithelial Cysts of the Pancreas: CT and MRI Features
Objective: Describe CT and MRI features of the lymphoepithelial cyst (LEC) of the pancreas. Methods: The authors identified 13 cases of LEC by searching their institutional electronic medical archives from 2004 to 2020. All of the patients had CT scans and six patients had both a CT and MRI. The fi...
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European Medical Journal
2015-06-01
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| Series: | European Medical Journal |
| Online Access: | https://www.emjreviews.com/radiology/article/lymphoepithelial-cysts-of-the-pancreas-ct-and-mri-features-j190222/ |
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| author | Temel Tirkes Aashish Patel Harvey Cramer Sehnaz Evrimler John M. DeWitt Mohammad Al-Haddad |
| author_facet | Temel Tirkes Aashish Patel Harvey Cramer Sehnaz Evrimler John M. DeWitt Mohammad Al-Haddad |
| author_sort | Temel Tirkes |
| collection | DOAJ |
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Objective: Describe CT and MRI features of the lymphoepithelial cyst (LEC) of the pancreas. Methods: The authors identified 13 cases of LEC by searching their institutional electronic medical archives from 2004 to 2020. All of the patients had CT scans and six patients had both a CT and MRI. The final diagnosis was established either by fine-needle aspiration with cytopathology (n=6) or surgical resection (n=7). Results: The mean diameter of the cysts was 36 mm (range: 6–93 mm). Almost all of the cysts were exophytic (92%) and solitary (85%), favouring the tail (54%) or body (38%) of the pancreas. LECs were either oval (62%) or round (39%) and had well-defined contours. All LECs showed T2 hyperintensity and T1 hypointensity; however, the signal was heterogeneous. Diffusion-weighted imaging showed restricted diffusion in all cases. On CT, LECs commonly showed complex fluid density (>15 HU) with no visible septation, enhancement or calcification. Conclusion: LECs have a distinguishing feature on MRI, which is restricted diffusion on diffusion-weighted imaging. This is presumably secondary to the presence of keratin, which can be a helpful feature differentiating LECs from other pancreatic cystic neoplasms. Besides this, LECs predominantly appear as solitary and exophytic lesions, with complex fluid density on CT and heterogeneous hypointense T1 and heterogenous hyperintense T2 signal on MRI. |
| format | Article |
| id | doaj-art-eb2fe34ed2904ed5b9da11d4913c136e |
| institution | Kabale University |
| issn | 2397-6764 |
| language | English |
| publishDate | 2015-06-01 |
| publisher | European Medical Journal |
| record_format | Article |
| series | European Medical Journal |
| spelling | doaj-art-eb2fe34ed2904ed5b9da11d4913c136e2025-01-16T16:55:09ZengEuropean Medical JournalEuropean Medical Journal2397-67642015-06-0110110610.33590/emj/22-00053Lymphoepithelial Cysts of the Pancreas: CT and MRI FeaturesTemel Tirkes0Aashish Patel1Harvey Cramer2Sehnaz Evrimler3John M. DeWitt4Mohammad Al-Haddad5Department of Radiology, Indiana University School of Medicine, Indianapolis, USADepartment of Radiology, Indiana University School of Medicine, Indianapolis, USADepartment of Pathology, Indiana University School of Medicine, Indianapolis, USADepartment of Radiology, Suleyman Demirel University School of Medicine, Isparta, TϋrkiyeDivision of Gastroenterology, Indiana University School of Medicine, Indianapolis, USADivision of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, USA Objective: Describe CT and MRI features of the lymphoepithelial cyst (LEC) of the pancreas. Methods: The authors identified 13 cases of LEC by searching their institutional electronic medical archives from 2004 to 2020. All of the patients had CT scans and six patients had both a CT and MRI. The final diagnosis was established either by fine-needle aspiration with cytopathology (n=6) or surgical resection (n=7). Results: The mean diameter of the cysts was 36 mm (range: 6–93 mm). Almost all of the cysts were exophytic (92%) and solitary (85%), favouring the tail (54%) or body (38%) of the pancreas. LECs were either oval (62%) or round (39%) and had well-defined contours. All LECs showed T2 hyperintensity and T1 hypointensity; however, the signal was heterogeneous. Diffusion-weighted imaging showed restricted diffusion in all cases. On CT, LECs commonly showed complex fluid density (>15 HU) with no visible septation, enhancement or calcification. Conclusion: LECs have a distinguishing feature on MRI, which is restricted diffusion on diffusion-weighted imaging. This is presumably secondary to the presence of keratin, which can be a helpful feature differentiating LECs from other pancreatic cystic neoplasms. Besides this, LECs predominantly appear as solitary and exophytic lesions, with complex fluid density on CT and heterogeneous hypointense T1 and heterogenous hyperintense T2 signal on MRI.https://www.emjreviews.com/radiology/article/lymphoepithelial-cysts-of-the-pancreas-ct-and-mri-features-j190222/ |
| spellingShingle | Temel Tirkes Aashish Patel Harvey Cramer Sehnaz Evrimler John M. DeWitt Mohammad Al-Haddad Lymphoepithelial Cysts of the Pancreas: CT and MRI Features European Medical Journal |
| title | Lymphoepithelial Cysts of the Pancreas: CT and MRI Features |
| title_full | Lymphoepithelial Cysts of the Pancreas: CT and MRI Features |
| title_fullStr | Lymphoepithelial Cysts of the Pancreas: CT and MRI Features |
| title_full_unstemmed | Lymphoepithelial Cysts of the Pancreas: CT and MRI Features |
| title_short | Lymphoepithelial Cysts of the Pancreas: CT and MRI Features |
| title_sort | lymphoepithelial cysts of the pancreas ct and mri features |
| url | https://www.emjreviews.com/radiology/article/lymphoepithelial-cysts-of-the-pancreas-ct-and-mri-features-j190222/ |
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