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Findings emphasize multimodal decision-making combining imaging, EUS evaluation, and cyst fluid analysis, with ongoing advances in biomarker development.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/identifying-neoplastic-versus-non-neoplastic-pancreatic-cystic-lesionswhat-is-the-current-evidence/371906/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/identifying-neoplastic-versus-non-neoplastic-pancreatic-cystic-lesionswhat-is-the-current-evidence/371906.png","ImageObject",300,407,{"name":42,"@type":43},"Guten 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\n[https://doi.org/10.1007/s10620-025-09320-4](https://doi.org/10.1007/s10620-025-09320-4)  \nIdentifying Neoplastic Versus Non‑neoplastic Pancreatic Cystic Lesions—What Is the Current Evidence?  \nArjun Chatterjee1 · Renan Prado2 · Clifton G. Fulmer3 · Christopher Coppa4 · Daniel Joyce5 · Syed Mohiuddin1 · Prabhleen Chahal6 · Tyler Stevens1  \nReceived: 30 January 2025 / Accepted: 22 July 2025 / Published online: 31 July 2025 © The Author(s) 2025  \nAbstract  \nBackground The widespread use of modern, high-resolution cross-sectional imaging has led to increased detection of pancreatic cystic lesions (PCLs), which have varying malignant potential. While most require periodic radiographic surveillance, some warrant biopsy or surgical excision.  \nMethods We conducted a narrative review of the literature focusing on the diagnostic accuracy of imaging and the role of endoscopic and molecular tools in PCL evaluation.  \nResults Cross-sectional imaging correctly classifies cyst type based on morphological features in approximately 50% of cases, with MRI generally outperforming CT. Endoscopic ultrasonography (EUS) is particularly useful when clinical and imaging findings are inconclusive or when high-risk features are present. In selected cases, such features may prompt direct surgical intervention. EUS-guided fine-needle aspiration of cyst fluid for chemical, genetic, and cytological analysis helps differentiate neoplastic mucinous cysts—such as intraductal papillary mucinous neoplasms and mucinous cystic neoplasms—from benign, non-mucinous cysts.  \nConclusions Accurate diagnosis of PCLs requires a multimodal approach combining high-quality imaging, EUS evaluation, and cyst fluid analysis. Advances in biomarker development hold promise for improving risk stratification and guiding individualized management strategies.  \nKeywords Pancreatic cyst · Biomarkers · CEA · Cyst fluid glucose · Confocal laser endomicroscopy · Next generation sequencing  \n* Arjun Chatterjee [chattea2@ccf.org](chattea2@ccf.org)[ ](chattea2@ccf.org)Renan Prado [prador2@ccf.org](prador2@ccf.org)[ ](prador2@ccf.org)Clifton G. Fulmer [fulmerc@ccf.org](fulmerc@ccf.org)[ ](fulmerc@ccf.org)Christopher Coppa [coppac@ccf.org](coppac@ccf.org)[ ](coppac@ccf.org)Daniel Joyce [joyced@ccf.org](joyced@ccf.org)  \nSyed Mohiuddin  \n[mohiuds2@ccf.org](mohiuds2@ccf.org)[ ](mohiuds2@ccf.org)Prabhleen Chahal [chahalp@uthscsa.edu](chahalp@uthscsa.edu)[ ](chahalp@uthscsa.edu)Tyler Stevens [stevens@ccf.org](stevens@ccf.org)  \n1 Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, USA  \n2 Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA  \n3 Diagnostics Institute, Department of Pathology, Cleveland Clinic Foundation, Cleveland, OH, USA  \n4 Department of Radiology, Cleveland Clinic Foundation, Cleveland, OH, USA  \n5 Department of General Surgery, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH, USA  \n6 Division of Gastroenterology, University of Texas Health, San Antonio, TX, USA  \nIntroduction  \nPancreatic cystic lesions (PCL) are often discovered “incidentally” during cross-sectional imaging. The prevalence of PCL in adults is between 2.6 and 19.6%, with a pooled prevalence of up to 8%[1, 2] . PCLs constitute a wide variety of cystic lesions with varying malignant potential. The most common neoplastic cysts with malignant potential are intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasm (MCN) . Serous cystadenomas (SCA), though neoplastic, are benign, whereas pseudocysts are nonneoplastic lesions [3] .  \nAlthough the majority of these lesions do not proceed to cancer, their high incidence and unknown malignant potential generate concern for patients and physicians alike [4 , 5] . As a result, before making care decisions, PCLs must be diagn","cbCaiclOttdg4hhZ","https://ap.wps.com/l/cbCaiclOttdg4hhZ","pdf",1516749,14,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# Introduction\n# Epidemiology and Classification of PCLs\n## Non-neoplastic PCLs\n## Neoplastic PCLs\n## Distinguishing IPMNs and MCNs\n## Clinical patterns","[{\"question\":\"Why has detection of pancreatic cystic lesions increased recently?\",\"answer\":\"Widespread use of modern, high-resolution cross-sectional imaging has led to more frequent detection of pancreatic cystic lesions.\"},{\"question\":\"How do cross-sectional imaging results affect classification of pancreatic cysts?\",\"answer\":\"Cross-sectional imaging can classify cyst type based on morphological features in about half of cases, with MRI generally outperforming CT.\"},{\"question\":\"What role does endoscopic ultrasonography (EUS) play in pancreatic cyst evaluation?\",\"answer\":\"EUS is particularly helpful when clinical and imaging findings are inconclusive or when high-risk features are present, and it supports cyst fluid sampling for chemical, genetic, and cytological analysis to help differentiate neoplastic mucinous cysts from benign non-mucinous cysts.\"}]","Identifying Neoplastic Versus Non-neoplastic Pancreatic Cystic Lesions—What Is the Current Evidence? | PDF",1790193155,35]