Presented in part at the 101st Annual Meeting of the United States and Canadian Academy of Pathology; March 17-23, 2012; Vancouver, British Columbia, Canada.
Cercariform cells: Another cytologic feature distinguishing solid pseudopapillary neoplasms from pancreatic endocrine neoplasms and acinar cell carcinomas in endoscopic ultrasound-guided fine-needle aspirates†
Article first published online: 5 DEC 2012
Copyright © 2012 American Cancer Society
Volume 121, Issue 6, pages 298–310, June 2013
How to Cite
Samad, A., Shah, A. A., Stelow, E. B., Alsharif, M., Cameron, S. E. H. and Pambuccian, S. E. (2013), Cercariform cells: Another cytologic feature distinguishing solid pseudopapillary neoplasms from pancreatic endocrine neoplasms and acinar cell carcinomas in endoscopic ultrasound-guided fine-needle aspirates. Cancer Cytopathology, 121: 298–310. doi: 10.1002/cncy.21259
- Issue published online: 13 JUN 2013
- Article first published online: 5 DEC 2012
- Manuscript Accepted: 8 OCT 2012
- Manuscript Revised: 27 SEP 2012
- Manuscript Received: 22 JUN 2012
- cercariform cells;
- solid pseudopapillary neoplasm;
- pancreatic endocrine neoplasm;
- acinar cell carcinoma;
- endoscopic ultrasound-guided fine-needle aspiration;
Solid pseudopapillary neoplasm (SPPN) is a rare tumor of unknown origin that occurs predominantly in the body or tail of the pancreas in young women. The authors recently identified cercariform (Greek: tailed) cells, similar to those described in urothelial carcinomas, as a consistent cytologic feature in ultrasound-guided fine-needle aspiration (EUS-FNA) samples from SPPNs. The objective of the current multi-institutional study was to define the value of these cells in the differential diagnosis of SPPN with other neoplasms characterized cytologically by the presence of monotonous, uniform cells in pancreatic aspirates: pancreatic neuroendocrine tumors (Pan-NETs) and acinar cell carcinomas (ACCs).
The files of 4 academic hospitals were searched for SPPNs, Pan-NETs, and ACCs that were diagnosed by EUS-FNA. The slides were reviewed, and several cytologic features were recorded semiquantitatively to identify discriminating features between SPPNs, Pan-NETs, and ACCs.
From the analysis of 18 SPPNs, 4 ACCs, and 20 Pan-NETs, the following cytologic features were identified as common to all 3 neoplasms: single cells and rosettes/acinar cell groups, round-to-plasmacytoid cells, pale-to-granular cytoplasm, fine vacuoles, and binucleated cells. Papillary structures, cercariform cells, large cytoplasmic vacuoles, reniform nuclei, hyaline globules/magenta-colored material, and degenerative features (cholesterol crystals, calcifications, foam cells, or giant cells) were significantly more common in SPPNs. Prominent nuclear grooves were encountered in only 4 of 18 SPPNs.
The current results indicated that the presence of cercariform cells is another useful clue for the cytologic diagnosis of SPPN in challenging cases. Cancer (Cancer Cytopathol) 2013;121:298–310. © 2012 American Cancer Society.