Metastases, Secondary Tumors, and Lymphomas of the Pancreas

The pancreas is infrequently the site of secondary involvement by solid or hematopoietic malignancies. While carcinomas and melanoma are the most common malignancies to secondarily involve the pancreas, the literature is replete with reports of uncommon and rare entities metastasizing to the pancreas. Fine-needle aspiration is indicated to establish the diagnosis and direct patient management. Diagnostic accuracy depends on correlation with clinical and imaging findings, previous pathology if known, and selection of the appropriate ancillary studies. Here we review the cytopathology of secondary tumors involving the pancreas and provide an approach to the diagnostic work-up.