Cytomorphological Evaluation of Solid Pseudopapillary Neoplasm of the Pancreas: A Lesser Explored Entity

Solid pseudopapillary neoplasm is an unusual neoplasm of the pancreas with uncertain to low malignant potential. It accounts for 1% of pancreatic neoplasms and 3% of cystic lesions, harbouring better prognosis than other neoplasms of the pancreas having close differential diagnosis. Patients are commonly young women presenting with abdominal discomfort. Aim was to study the cytomorphological features of solid pseudopapillary neoplasm of pancreas diagnosed on Fine Needle Aspiration Cytology (FNAC) and its cyto-histological correlation. Cytology smears of five solid pseudopapillary neoplasms reported over the last five years were retrieved from the archives of pathology. The smears were evaluated for cytomorphological features and correlated with histopathology. All five cases had characteristic features on cytology such as pseudorossettes, cells having fine chromatin, indented nucleus and vacuolated cytoplasm. Histopathological correlation was available in all cases out of which four had features consistent with solid pseudopapillary neoplasm. However, one case was diagnosed as acinarcell carcinoma which was confirmed by immunohistochemistry. The cytomorphology on FNAC plays a pivotal role in the management of the patient. Surgical resection of the neoplasm can be done with retention of the uninvolved pancreas to avoid subsequent complications.