Lymphoepithelial cysts of the pancreas: endosonography-guided fine needle aspiration.

Lymphoepithelial cyst (LEC) of the pancreas is a rare lesion. Here, we report three cases that we encountered during 2007 in our institution, which were evaluated by endosonography (EUS) and fine needle aspiration (FNA). All three patients were male with ages ranging from 47 to 77 years. Each patient had a single, cystic mass of the body/tail of the pancreas that was found incidentally on CT scan. The size of the masses ranged from 3 to 6.5 cm radiologically. For each patient, EUS showed a well-circumscribed, lobulated mass with smooth contours; the remainder of the pancreas appeared normal without ductal dilation. FNA of all three masses demonstrated predominantly anucleated squamous cells, amorphous keratinous debris, and lymphocytes. Cholesterol crystals were present in one case. One patient underwent surgical resection and the diagnosis of LEC was confirmed histologically. In conclusion, pancreatic LECs are extremely rare, benign cystic lesions. FNA study may help to render a correct diagnosis and reduce unnecessary surgery.