Document Detail

Variability in cyst fluid carcinoembryonic antigen level, fluid viscosity, amylase content, and cytologic findings among multiple loculi of a pancreatic mucinous cystic neoplasm.
MedLine Citation:
PMID:  7692722     Owner:  NLM     Status:  MEDLINE    
The procedure of percutaneous aspiration and analysis of cyst contents has been advocated to provide a preoperative diagnosis of pancreatic cystic lesions (pseudocysts and cystic tumors), but it is not known whether variation in the contents of separate loculi of a multilocular neoplasm might misrepresent the identity of the tumor. The authors measured the cyst fluid carcinoembryonic antigen (CEA) level, fluid viscosity, and amylase content and performed cytologic analysis on aspirates rates from ten different loculi of a single mucinous cystic neoplasm of the pancreas. The CEA levels were highly variable (median, 6,326 ng/mL; range, 962-64,670 ng/mL) but in all cases were diagnostic of a mucinous tumor. Fluid relative viscosity values were also variable (median, 2.4; range, 1.3-10+) but diagnostic in eight of nine aspirates. The amylase content in all of the loculi was low (< 91 U/L), and values were consistent with a cystic tumor. Cytologic analysis showed diagnostic mucin-secreting epithelial cells in nine of ten loculi. Although cytologic examination was nondiagnostic in one loculus, there were no false-positive results for malignancy. The combination of all four tests would not have resulted in misclassification of any of the tumors. The authors conclude that the characteristics of the contents of different loculi of pancreatic cystic neoplasms may be variable, but the use of a combination of tests still ensures accurate diagnosis.
K B Lewandrowski; A L Warshaw; C C Compton; M R Pins; J F Southern
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of clinical pathology     Volume:  100     ISSN:  0002-9173     ISO Abbreviation:  Am. J. Clin. Pathol.     Publication Date:  1993 Oct 
Date Detail:
Created Date:  1993-11-15     Completed Date:  1993-11-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370470     Medline TA:  Am J Clin Pathol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  425-7     Citation Subset:  AIM; IM    
Department of Pathology, Massachusetts General Hospital, Boston 02114.
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MeSH Terms
Amylases / metabolism*
Body Fluids / metabolism
Carcinoembryonic Antigen / metabolism*
Cysts / metabolism*,  pathology
Mucins / secretion
Pancreatic Neoplasms / metabolism*,  pathology
Reg. No./Substance:
0/Carcinoembryonic Antigen; 0/Mucins; EC 3.2.1.-/Amylases

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