To describe the most common pancreatic cystic lesions and the most adequate diagnostic tools for their characterization.

As sectional imaging (CT and MRI) develops more everyday, the more pancreatic cystic lesions are diagnosed. Most of these lesions are benign or low-grade indolent neoplasms. However, in a significant number of cases a pre-malignant lesion or even a malignant one is diagnosed. The radiologist’s role shouldn’t only be of its detection but also its characterization. When we can’t achieve a full characterization with a diagnosis (very small lesions or lesions with unspecific features) we should alert the referring physician for those with malignant potential....

The most frequent pancreatic cystic lesions are: pseudocysts, Serous cystadenomas (microcystic type), mucinous cysts and solid pseudopapillary tumor. There are other, less frequent, pancreatic cystic lesions such as: cystic endocrine tumors, cystic pancreatic adenocarcinoma, cystic metastasis, cystic teratomas and lymphangiomas. In this EPOS we will only discuss the most frequent pancreatic lesions. Most frequent pancreatic cystic lesions: Pancreatic pseudocysts Pseudocysts are a complication of interstitial edematous pancreatitis. They are filled with pancreatic juices (rich in amylase and lipase) surrounded by a wall formed by granulation...

Radiologists should be familiarized with the radiological features of the most frequent pancreatic cystic lesions. When an adequate characterization cannot be achieved, radiologists can play a role in the management of the patient, suggesting the next diagnostic or therapeutic step. This next step can be the performance of EUS with FNA, lesion’s follow-up or surgical resection, if a lesion has worrisome features.

Dewhurst CE, Mortele KJ; “Cystic tumors of the pancreas: Imaging and Management”; Radiol Clin N Am 2012; 50:467–486 Bollen TL, “Imaging of acute pancreatitis: Update of revised Atlanta classification” ;Radiol Clin N Am 2012; 50:429–445 Megibow AJ, Baker ME, Gore R, Taylor A; “The incidental pancreatic cyst”; Radiol Clin N Am 2011; 49:349-359 Kalb B, Sarmiento JM, Kooby DA, Adsay NV, Martin DR; “MR Imaging of cystic lesions of the pancreas”; RadioGraphics 2009; 29:1749-1765