Clinicians at the Mass General CIST Center diagnose, treat and monitor patients with pancreatic cystic lesions.

Drs. Forcione, Brugge and Bounds  

The CIST Team

The Cyst Imaging Surveillance and Treatment (CIST) Center includes providers in Gastroenterology, Surgery, Pathology and Radiology. Drs. Forcione, Brugge and Casey make up the gastroenterology team. They provide consultations regarding diagnosis and management.

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Blake 4
55 Fruit Street
Boston, MA 02114
617-724-0578

Physician highlights

Dr. Carlos Fernández-del Castillo was part of the group of international experts that met in Sendai, Japan in 2004 and organized the guidelines for the management of IPMNs and mucinous cystic neoplasms. These guidelines have been implemented across the world. Dr. Fernandez has also been instrumental in the organization of a new set of guidelines that will offer even more specifics regarding surveillance and diagnosis.

Dr. Martha Bishop Pitman, Director of the Cytopathology Laboratory, is an internationally recognized leader in the field of cytopathology in general, and pancreatic cytology in particular. Her primary research focus is on the clinical utility of pancreatic cyst cytology for diagnosis and management of patients with pancreatic cysts. Her studies have led to the recognition of the value of cytological evaluation of cyst fluid in the determination of cyst type and on the recognition of premalignant changes that prompt surgical management prior to the development of invasive carcinoma. Along with Dr. Carlos Fernandez-del Castillo and a multidisciplinary team of physicians from around the world, she contributed the sole voice of the cytopathologist to the revision of the 2006 Sendai Guidelines for the management of patients with mucinous cysts of the pancreas. Dr. Pitman authored the section on interpretation of cytology from aspirated cystic neoplasms. She is also leading an international group on the development of standardized guidelines for nomenclature and diagnostic criteria of pancreatobiliary cytology through the Papanicolaou Society of Cytopathology.

Cyst fluid cytology

An example of how cyst fluid cytology correlates with the histologic type of IPMN. The left panel demonstrates benign IPMN, followed by moderate dysplasia in the middle panel and high grade dysplasia in the right panel.