Pancreatic Cysts

Question 1

What is a pancreatic cyst

Answer 1

Collection of fluid in the pancreas that is divided into true cysts - non inflammatory and pseudocyst - inflammatory

Question 2

Which cyst is high risk and which cyst is low risk

Answer 2

High risk - mucinous

Low risk - serous cysts

Question 3

What are the clinical features of pancreatic cyst

Answer 3

70% are asymptomatic
Some pts present with abdo pain
obstructive jaundice
Cysts can become infected therefore would get systemic infection signs

Question 4

What are the differential diagnosis for pancreatic cysts

Answer 4

Pancreatic pseudocysts - collection of fluid within a area of necrosis.

Question 5

What is a pancreatic pseudocyst

Answer 5

Fluid build up in pancreas without a epithelial/endothelial lining

Question 6

How would you investigate pancreatic cysts

Answer 6

Most cysts are picked up incidentally on imaging + baseline bloods
CT pancreas
EUS with FNA

Question 7

What criteria makes a cyst low risk from imaging

Answer 7

1. Cyst diameter < 3cm
2. Central calcification
3. Asymptomatic

Question 8

What criteria make a cyst high risk on imaging

Answer 8

1. Cyst diameter > 3cm
2. Enhancing solid component
3. Non-enhancing mural node

Question 9

What treatment are available for high risk pancreatic cysts

Answer 9

Surgical resection with follow up every 2 years with MRI scan

Question 10

How would you treat low risk pancreatic cysts

Answer 10

Surveillance every 5 years