Pancreatic cysts

Question 1

What are pancreatic cysts?

Answer 1

collections of fluids that form within the pancreas

Question 2

How are pancreatic cysts classified?

Answer 2

Secretions, histology, risk of malignancy

Question 3

What type of cysts are higher risk of cancer?

Answer 3

mucinous rather than serous

Question 4

What are the clinical features of pancreatic cysts?

Answer 4

asymptomatic usually but may get abdominal or back pain, post obstructive jaundice and vomiting, infection may cause systemic features

Question 5

What are the differential diagnosis of pancreatic cysts?

Answer 5

Pancreatic psuedocysts

Question 6

What are the investigations for pancreatic cysts?

Answer 6

Pancreatic protocol CT scan or MRCP, then may need complete resection or endoscopic US scan with one needle aspiration

Question 7

what cystic features would be low risk on imaging?

Answer 7

Cyst diameter <3cm
Cystic morphology with central calcification
Asymptomatic

Question 8

What cystic features would be high risk on imaging?

Answer 8

Cyst diameter >3cm
Main pancreatic duct dilatation greater than 10mm
Enhancing solid component
Non-enhancing mural nodule

Question 9

What is the management for pancreatic cysts?

Answer 9

surveillance only, resection should be first use if high risk cysts then an MRI scan later