Solid-Pseudopapillary Neoplasm of Pancreas: Insights from Cytopathology

Background: Solid-pseudopapillary neoplasm (SPEN) is a rare pancreatic tumor, constituting 2–3% of all pancreatic neoplasms, primarily affecting young women with a median age of 30. Its prognosis is generally favorable due to the low incidence of metastasis and successful surgical resection. Accurate preoperative diagnosis is crucial, as its cytological features are distinctive. Aim: To elucidate the significance of cytopathology in the detection of SPEN, associated diagnostic pearls and pitfalls, and histopathologic correlation. Materials and Methods: All SPEN cases diagnosed through cytomorphology were retrieved from the hospital medical records, and relevant clinical information was compiled. Cytopathology and histopathology slides were obtained from the archives and reviewed. Results: All four cases were middle-aged women (mean age = 40 years) presenting with abdominal pain. Imaging showed solid-cystic lesions. The diagnosis of SPEN was rendered on fine needle aspiration cytology (FNAC), with characteristic papillary and glandular patterns. Histology confirmed the diagnosis with 100% cytohistological concordance in all four cases. Conclusion: FNAC is an effective tool for the detection of SPEN, allowing precise diagnosis, guiding surgery, and reducing the need for extensive resection.