Pancreatic cystic lesions: How endoscopic ultrasound morphology and endoscopic ultrasound fine needle aspiration help unlock the diagnostic puzzle

Table 3 Endoscopic ultrasound morphology and cystic fluid analysis in pancreatic cystic lesions

	Serous cystoadenoma	Mucinous cystic neoplasm	BD-IPMN	Pseudocyst
Localization
Head	+++	+/-	+++	++
Body-tail	++	+++	++	++
Locularity
Unilocular	+	+	+	+++
Multilocular	+++	+++	+++	+
Internal structural features
Microcystic aspect	+++	-	+	-
Bunch of grape aspect	+	-	+++	-
Countors
Round	+	+++	+	+++
Lobulated	+++	+/-	+	+/-
Irregular	+/-	-	+++	-
Central scar	+	-	-	-
Visible cystic wall	-	++	+	+/++
Multifocality	-	-	++	+/-
Debris	-	-	-	++
Visible comunication with pancreatic duct	-	-	++	+
Calcification
Central	+	-	-	-
Periphery	-	+	-	+/-
Solid lesion	-	+	+	-
CEA
≥ 192 mg/mL	+/-	++	++	+/-
≥ 5 mg/mL	+	+++	+++	++
≤ 5 mg/mL	+++	+/-	+/-	+
Amylase
> 250 U/L	+	+/++	++/+++	+++
K-RAS mutation	-	++	++	-
Mucin	-	+	+	-
Cytology	Glycogen	Mucinous	Mucinous	Inflammatory

+++: Very frequent; ++: Moderately frequent; +: Infrequent; +/-: Possible but very infequent. BD-IPMN: Branch duct intraductal papillary mucinous neoplasm; CEA: Carcinoembryonic antigen.