Fine-needle aspiration of solid and papillary cystic tumor of the pancreas

Solid and papillary cystic tumors of the pancreas are relatively rare tumors that occur in adolescent and young adult women. A case is presented in which preoperative diagnosis was made by fine-needle aspiration biopsy obtained under computed tomographic guidance. The cytologic smears were characterized by branching, papillary clusters of cells having a thin, well-defined, fibrovascular core and surfaced by multiple layers of cells. Sheets of cells were also present. The tumor cells had small, round to oval nuclei with finely stippled chromatin and an occasional small nucleolus. The nuclear membrane was delicate and nuclear infolding was frequent. The cytoplasm was scant and cell borders were indistinct. Mitotic figures were notably absent. The diagnosis was confirmed histologically following surgical resection. As this tumor has a favorable prognosis with complete surgical removal, fine-needle aspiration can play an important role in preoperative planning by distinguishing it from other pancreatic lesions with significantly different prognosis and treatment. Therefore, pediatric pathologists should be familiar with the cytologic manifestations of this tumor.