Pancreatic lymphoepithelial cyst with an intracystic papillary projection. Report of a case

Lymphoepithelial cysts of the pancreas show various presentations on imaging studies often making a differential diagnosis difficult. A 58-year-old man was admitted to our hospital with epigastric discomfort and abdominal bloating. Abdominal US was carried out and demonstrated a cystic lesion 5 cm in diameter which included an intracystic projection into the pancreatic body. This intracystic projection was also seen on CT and MR images. On FDG-PET images, the projection was positively visualized. Since we could not exclude a pancreatic cystic neoplasm, a distal pancreatectomy was performed. Postoperative pathological examination demonstrated that the lesion was a lymphoepithelial cyst of the pancreas. There were no atypical cells in the intracystic projection. Resection is inevitable when a true pancreatic neoplasm cannot be excluded.