NDLI: Epidermoid cyst in an intrapancreatic accessory spleen: three case reports and review of the literatures.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kadota, Kyuichi Kushida, Yoshio Miyai, Yumi Katsuki, Naomi Hayashi, Toshitetsu Bando, Kenji Shibuya, Shinsuke Haba, Reiji
Description	Country affiliation: Japan Author Affiliation: Kadota K ( Department of Diagnostic Pathology, University Hospital, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kagawa, Japan. qichi@med.kagawa-u.ac.jp)
Abstract	The development of an epidermoid cyst in an intrapancreatic accessory spleen is an extremely rare lesion, with only 17 cases being reported in the English literature. All such cases were located in the pancreatic tail, some of which showed carbohydrate antigen 19-9 (CA19-9) immunoreactivity in the lining of the epithelium. A few of them indicated an elevation of the serum CA19-9 level. Here we report three cases of an epidermoid cyst in an intrapancreatic accessory spleen. Cases 1 and 2 were 57-year-old and 70-year-old women, while case 3 was a 37-year-old man. All three cases were asymptomatic. Serum CA19-9 levels showed within normal limits (case 1), slightly elevated (case 2), and clearly elevated (case 3). They underwent a distal pancreatectomy with splenectomy (cases 1 and 2) and without splenectomy (case 3). Grossly, the surgical specimen was a well-demarcated, multiple (case 1) or solitary (cases 2 and 3) cystic mass in the pancreatic tail. A high level of fluid CA 19-9 was detected in case 1. Microscopically, the cystic walls were lined with squamous and cuboidal epithelium, which were surrounded by normal splenic tissue and hyalinized fibrous tissue. The lining squamous epithelium was revealed as nonkeratinizing (Cases 1 and 2) or keratinizing (Case 3). Immunohistochemically, CA19-9 was positive in the monolayer and surface layer of the cuboidal epithelium, but negative for the keratinizing squamous epithelium. As for the histogenesis, it is suggested that the cystic lining of the epithelium may derive from the pancreatic duct which protrudes into the accessory spleen.
File Format	HTM / HTML
ISSN	12194956
Issue Number	3
Volume Number	16
e-ISSN	15322807
Journal	Pathology & Oncology Research
Language	English
Publisher	Springer
Publisher Date	2010-09-01
Publisher Place	Netherlands
Access Restriction	Subscribed
Subject Keyword	Discipline Oncology Choristoma Pathology Epidermal Cyst Pancreatic Diseases Spleen Adult Aged Biological Markers Blood Ca-19-9 Antigen Carcinoembryonic Antigen Female Humans Male Middle Aged Case Reports Journal Article Review
Content Type	Text
Resource Type	Case study Article
Subject	Cancer Research Pathology and Forensic Medicine Oncology

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