Investig Magn Reson Imaging.  2018 Mar;22(1):61-64. 10.13104/imri.2018.22.1.61.

Lymphoepithelial Cyst in Pancreas: a Case Report with Magnetic Resonance Imaging Findings

• Kim HJ
• Park MH

• KMID: 2408819
• DOI: http://doi.org/10.13104/imri.2018.22.1.61

Abstract

Pancreatic lymphoepithelial cysts (LECs) are rare pancreatic cysts with squamous epithelial lining surrounded by dense lymphoid tissue. A preoperative diagnosis of LECs is difficult due to imaging diversity and inadequate documentation because of their rarity. We present a case of surgically confirmed pancreatic LEC with magnetic resonance imaging (MRI) findings as heterogeneous signal intensity on T2-weighted images with multiple septa-like structures, slightly hypo-signal intensity on T1-weighted images, and thin-wall enhancement on dynamic contrast images. LECs are benign lesions without any malignant potential. Therefore, the inclusion of LEC in the differential diagnosis of cystic pancreatic lesions may reduce unnecessary surgical procedures.

Keyword

Magnetic resonance imaging; Lymphoepithelial cyst; Pancreas

MeSH Terms

Diagnosis
Diagnosis, Differential
Lymphoid Tissue
Magnetic Resonance Imaging*
Pancreas*
Pancreatic Cyst

Figure

• 

  Fig. 1 A lymphoepithelial cyst of the pancreas in a 59-year-old man. A 1.3-cm-sized well-defined oval lesion is seen in the pancreatic tail portion with an exophytic appearance. The lesion shows isoattenuation with pancreas on precontrast CT scan (a) and thin peripheral wall enhancement on postcontrast CT scan (b). On T2-weighted image (c), the lesion shows heterogeneous signal intensity with multiple septa-like structures present inside. The lesion shows slightly hypo-signal intensity on the precontrast T1-weighted image (d) with thin peripheral wall enhancement on arterial (e), portal (f), and 3-min delayed phase (g) images of a dynamic contrast enhancement study. The lesion shows high signal intensity on axial high b-value image (b = 800 s/mm2) (h); however, the ADC map (i) reveals no diffusion restriction. Photograph of the gross surgical specimen (j) demonstrates cystic nodule with the pale yellowish surface, filled with keratin material, and encapsulated by a fibrous capsule.

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