Pancreatic Cyst

Incidental Pancreatic Cyst

Algorithms

ANY Incidental Pancreatic Cyst in patient >80 y/o

<1.5cm Incidental Pancreatic Cyst

1.5 - 2.5cm Incidental Panc Cyst WITH Main Duct communication

1.5 - 2.5cm Incidental Panc Cyst W/O (or indeterminate) Main Duct communication

>2.5cm Incidental Panc Cyst

ACG Guidelines (Gastroenterology)

"Worrisome Features"

• Cyst >= 3cm long axis
• Thickened/enhancing cyst wall
• Nonenhancing mural nodule
• Main pancreatic duct >= 7mm at thickest point

"High-Risk Stigmata"

• Obstructive jaundice with cyst in head of pancreas
• Enhancing solid component within cyst
• Main pancreatic duct >=10mm in absence of obstruction

Growth Definition

• Size <0.5cm: 100% increase in long axis diameter
• >0.5 and <1.5cm: 50% increase in long axis
• >1.5cm: 20% increase in long axis

Things to Report

1. Morphology and location
2. Size
3. Possible communication with MPD
4. Presence of "worrisome features" or "high-risk stigmata"
5. Growth on f/u exam
6. Multiplicity

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