Johns Hopkins Pathology
 
Key Points:
CT
  • Thick well-defined wall
  • Fine Needle Aspiration
  • Granular debris and lipid droplets
Images: Pseudocyst |

CT and ultrasonography are usually effective in the diagnosis of pseudocysts. A CT/ultrasonography guided fine needle aspiration biopsy shows material consisting of granular debris and lipid droplets, and a few inflammatory cells such as neutrophils, macrophages, and a few plasma cells. The fluid characteristically has a high amylase level.

On plain CT, pseudocysts appear as a collection of fluid and show a thick well-defined wall. Pseudocysts that do not appear homogenous or show an increase in attenuation, may reveal hemorrhage or infection. ERCP and MRCP can be useful since they can display the relations between the pancreatic duct and the pseudocysts.

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