Two cases of peripancreatic cystic lymphangiomas diagnosed by EUS-guided FNA

Case 1 : A 51-year old male was referred for evalua- tion of a large cystic mass inferior to the uncinate process of the pancreas and anterior to the 3rd portion of the duodenum. He was asymptomatic. No abdominal tenderness or mass was appreciated. MRCP and MRI of the pancreas showed a T2 hyperintense, microlobulated, multiseptated, and multi-cystic mass measuring 6.0 x 5.1 x 3.6 cm overall. Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) of the cyst yielded 18 mL of milky-white fluid (Figure 1). Analysis of the cyst fluid revealed a CEA of 27.3 ng/mL, amylase of 47 U/L, and triglycerides of 6162 mg/dL. Cytology showed no malignant cells. A repeat MRI was obtained at a 1 year interval and showed no change in the lesion.