Pancreas, Pancreatic serous cystadenoma, macrocystic variant

Serous cystadenoma is an important entity in the differential diagnosis of cystic lesions of the pancreas. This lesion typically presents with symptoms of local mass effect or as an incidental finding on imaging. It is an epithelial lesion characterized by cystic spaces lined by cytologically bland cuboidal cells with clear cytoplasm due to glycogen accumulation. It typically exhibits a multicystic growth pattern, but rarely can also exhibit oligocystic or macrocystic growth. Very rarely, serous cystic lesions demonstrate malignant behavior, including metastatic spread—these are classified as cystadenocarcinoma. This is an example of a benign serous cystadenoma exhibiting a macrocystic pattern of growth. There is also a focal papillary growth pattern in this example, a finding that is occasionally reported and has no clinical significance.