Related Experiment Video For Biomarkers
Updated: Sep 10, 2025
Management of the Uncinate Process in No-Touch Laparoscopic Pancreaticoduodenectomy
Published on: May 5, 2023
Identifying Neoplastic Versus Non-neoplastic Pancreatic Cystic Lesions-What Is the Current Evidence?
Arjun Chatterjee1, Renan Prado2, Clifton G Fulmer3
1Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, USA. chattea2@ccf.org.
Background:
The widespread use of modern, high-resolution cross-sectional imaging has led to increased detection of pancreatic cystic lesions (PCLs), which have varying malignant potential. While most require periodic radiographic surveillance, some warrant biopsy or surgical excision.
Methods:
We conducted a narrative review of the literature focusing on the diagnostic accuracy of imaging and the role of endoscopic and molecular tools in PCL evaluation.
Results:
Cross-sectional imaging correctly classifies cyst type based on morphological features in approximately 50% of cases, with MRI generally outperforming CT. Endoscopic ultrasonography (EUS) is particularly useful when clinical and imaging findings are inconclusive or when high-risk features are present. In selected cases, such features may prompt direct surgical intervention. EUS-guided fine-needle aspiration of cyst fluid for chemical, genetic, and cytological analysis helps differentiate neoplastic mucinous cysts-such as intraductal papillary mucinous neoplasms and mucinous cystic neoplasms-from benign, non-mucinous cysts.
Conclusions:
Accurate diagnosis of PCLs requires a multimodal approach combining high-quality imaging, EUS evaluation, and cyst fluid analysis. Advances in biomarker development hold promise for improving risk stratification and guiding individualized management strategies.
