Lymphoepithelial cyst of the pancreas: A challenging diagnosis on fine needle aspiration

Lymphoepithelial cysts (LECs) of the pancreas are rare, benign pancreatic cysts comprising approximately 0.5% of all pancreatic cysts. They occur predominantly in men in the 5th and 6th decades of life. LECs are true cysts lined by stratified squamous epithelium with adjacent subepithelial lymphoid tissue. They range in size from 1.2 to 17 cm (mean size 4.6 cm) and can arise in any part of the pancreas. 1 LEC resembles other benign and malignant pancreatic cysts clinically and radiologically. The cytomorphologic features of LECs have been described in a small number of case reports and it has been indicated that features may overlap with other benign and malignant pancreatic lesions. Herein, we report clinical, radiological, cytological and histopathological features of a pancreatic LEC in a 62-year-old male. •Lymphoepithelial cysts (LEC) are rare cystic lesions of the pancreas.•Cytologic features of lymphoepithelial cysts are distinctive but not always apparent on fine needle aspiration (FNA).•Keratin debris from lymphoepithelial cysts may stain spuriously positive with a mucicarmine special stain.•Endoscopic ultrasound-guided FNA can help in the preoperative diagnosis, and management of LEC.