Differentiating Common Pancreatic Cystic Lesions

Differentiating common primary pancreatic cystic neoplasms requires combining morphology with patient demographics.

Serous Cystadenoma: Older women; microcystic, lobulated mass. Pathognomonic central stellate scar with calcification in ~30%.

Mucinous Cystic Neoplasm: Middle-aged women; macrocystic in body/tail. Peripheral "eggshell" calcification suggests malignancy. Does not communicate with the pancreatic duct.

Intraductal Papillary Mucinous Neoplasm: Older adults; key feature is communication with the pancreatic duct on MRCP/CT.