Johns Hopkins Pathology
 
Key Points:
CT, MRI, EUS, MRCP
  • Sunburst pattern of calcification
  • Honeycomb pattern of microlacunae

Enhanced CT and Angiography
  • Hypervascularity
Images: Serous Cystic Cystadenoma #1 | Serous Cystadenoma #2 | Serous Cystadenoma #3 |

Although preoperative diagnosis of serous cystic neoplasms relies on CT and EUS images, neither modality, used independently or together, provides a definitive diagnosis.

Plain CT shows a honeycomb pattern of microlacunae, with thin septae separating different segments. Serous cystic neoplasms can have a sunburst pattern of central calcification, seen in 10-30% of cases. Peripheral calcification may be seen in some cases, leading to a differential diagnosis of mucinous cystic neoplasm or pseudocyst. MRI, EUS, and magnetic resonance cholangiopancreatography also show this same honeycomb pattern. Hypervascularity, a defining characteristic of serous cysts, can be seen through angiography and enhanced CT.

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