Diagnosis and Treatment of Pancreatic Lymphoepithelial Cyst

  Objective  The aim of this study was to investigate the clinical characteristics of pancreatic lymphoepithelial cyst (PLEC), a rare cystic lesion in the pancreas.

  Methods  The clinical data of patients with PLEC who underwent pancreatectomy from 2016 to 2019 in Peking Union Medical College Hospital were analyzed retrospectively. The clinical presentations and imaging features were summarized.

  Results  A total of 7 patients with PLEC were included in this study, including 4 males and 3 females. The average age was 49 years old. One patient suffered from abdominal distension and the other 6 showed no symptom. A unique round lesion in the pancreas was found in all cases with cross-section scanning. Five lesions were located in pancreatic body and tail, and two were found in pancreatic head and neck. Serum CA19-9 levels were above normal upper limit in two patients. ¹⁸F-FDG PET/CT was performed in two patients, which showed high intake in part of the cyst wall in one patient. The complications with pancreatectomy in this cohort were pancreatic fistulae in 3 patients and low body weight in one patient. No sign of recurrence was found during a median follow-up of 17 months.

  Conclusions  PLEC is a rare benign cystic lesion in the pancreas. The preoperative differential diagnosis was quite difficult with imaging examination and clinical presentations. A comprehensive diagnosis strategy with endoscopic ultrasonography aspiration biopsy may help for preoperative diagnosis. Asymptomatic patients can be considered for observation and follow-up.