Differentiating intraductal papillary mucinous neoplasms from other pancreatic cystic lesions

Table 2 Key questions to aid in making likely diagnoses[19]

	Key question	Likely diagnoses to consider
Demographics and history	Male?	MCN unlikely
	No history of pancreatitis?	PSEUDO unlikely
	Young female?	SPN
	History of MEN?	cNET
	History VHL?	SC
Imaging	Spheroid?	PSEUDO or MCN
	Central sunburst calcification?	SC
	Location in head?	MCN unlikely
Cyst fluid	No CEA/mucin?	IPMN or MCN unlikely
	High CEA, high amylase?	IPMN
	High CEA, low amylase	MCN
	Low CEA, high amylase?	PSUEDO
	High amylase?	IPMN or PSEUDO
Histology	Epithelial lining?	PSEUDO unlikely
	Ovarian stroma?	MCN

IPMN: Intraductal papillary mucinous neoplasm; MCN: Mucinous cystic neoplasm; SC: Serous cystadenoma; PSEUDO: Pancreatic pseudocyst; SPN: Solid-pseudopapillary neoplasm; VHL: Von hippel-lindau disease; MEN: Multiple endocrine neoplasia. These data are derived generalizations of the literature, with the understanding that there is significant overlap among cyst types and there are inherent sampling errors associated with various tests; diagnostic and treatment decisions should not rely solely on the information presented in this review. An electronic worksheet version of this table is available at http://pathology.jhu.edu/pancreas/professionals/ipmn.php