Differential diagnosis of asymptomatic patients with pancreatic small cystic lesions

Objective To analyze the differences between benign and potential malignant small pancreatic cystic lesions. Methods We retrospectively analyzed the clinical and pathological data of asymptomatic patients with pancreatic small cystic lesions and divided them into benign group (including serous cystic neoplasms, lymphoepithelial cyst and pseudocyst) and potential malignant group (including mucinous cystic neoplasms, intraductal papillary mucinous neoplasms and solid pseudopapillary neoplasms). Comparison of clinical data was made between the two groups. Results 46 patients with pathological results were included (22 cases in benign group and 24 cases in potential malignant group). No difference was detected on demographic data and lab results between the two groups. Compared with benign patients, patients in the potential malignant group were more likely to show thicken wall (P=0.000), mural nodule (P=0.000), solid constituents inside the cyst (P=0.001), wall enhancement (P=0.003) and uneven wall on CT scan (P=0.024). The diagnostic sensitivity, specificity and accuracy of the combination of above mentioned CT features for potential malignant diseases were 91.7%, 77.3% and 84.8%, respectively. Conclusions Pancreatic cystic lesions with thicken wall, mural nodule, wall enhancement, solid parts inside the cyst and uneven wall on CT were more likely of potential malignant entities. Key words: Pancreatic neoplasms; Diagnosis; Cystic lesion