Papillary-cystic tumor of the pancreas

A case of papillary cystic tumor (PCT) of the pancreas in a 40-yr-old woman is reported. This rare neoplasm was discovered fortuitously by a CT-scan examination for a palpable abdominal uterine leiomyoma. Percutaneous fine-needle aspiration (FNA) of the pancreatic mass was performed under CT-scan guidance. Cytologic examination of the material gave the diagnosis of PCT, which was confirmed by histologic examination of the resected tumor. Immunohistochemical staining showed a high degree of positivity to wide-spectrum anticytokeratin and anticytokeratin 20, and a weak positivity to anti-NSE antibody. In addition, the tumor cells were highly reactive for progesterone antibody, while they were negative for estrogen. These findings suggest a ductal origin for PCT, and also suggest that sex hormones may play a role in its growth, but not in its genesis. We emphasize the value of FNA cytologic features in the diagnosis of these rare tumors.