PMC9063648_01
Relatively hypocellular aspirates showed poorly preserved cells with myxoid debris and focal yellow refractile pigment (in both Pap and Diff Quik stained smears) without epithelial cells, except scant gastric mucosal contamination. [a (x 20)- Pap stain; b (x 20), c and d (x 100)- Diff-Quik stain].
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F1
EUS-FNA of a 2.3 cm cystic lesion in tail of pancreas of 50 year old American woman showed cytopathologic findings seen in Figure 1.
Cell-block of transgastric EUS-FNA cytology of cystic lesion in tail of pancreas. The sections showed reactive pancreatic ducts in ill-defined lobular architecture with sclerotic stroma without pancreatic acini. (H and E stained cell-block sections; (a) x10, (b) x20, (c) x40, (d) magnification of cropped area).
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F2
Many spindle cells with repair-like pattern were also noted [Figure 2].
Transgastric EUS-FNA cytology of cystic lesion in the tail of pancreas. Focal collection of polyhedral stromal histiocytes should not be confused with epithelial cells with myxoid debris in the background. This may lead to misinterpretation as mucinous cystic lesion (MCN or IPMN). (Diff-Quik stained direct smear, x40).
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F3
The cell-block (CB) showed stroma with reactive pancreatic ducts with mild chronic inflammation without pancreatic acini and malignancy [Figure 3].
Transgastric endoscopic EUS-FNA cytology of cystic lesion in the tail of pancreas. The direct smears showed spindle cells (a and b) and some polyhedral cells (c) with foam cells (d) in the background with myxoid debris (Diff-Quik stain; (a and b) x20; (c and d) x40).
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F4
Myxoid background in pancreatic pseudocysts may be difficult to distinguish from viscid mucin in mucinous cystic lesions [Figure 4].