Learning objectives
- To analize the different forms of pancreatic cystic neoplasms and their potential for malignancy.
- To expose the most suitable imaging methods for its characterization.
- To review the CT and MR findings of a variety of cystic neoplasms of the pancreas and their histopathologic correlation of cases that have undergone surgery in our hospital.
Background
Cystic pancreatic lesions are increasingly detected because of the improvement of CT and MR diagnostic techniques.
Pancreatic cystic lesions comprise a variety of categories including benign inflammatory and non-inflammatory conditions (pseudocyst or neoplasm such as serous cystadenoma -SCN-),
premalignant like mucinous cystic neoplasia (MCN) and papillary intraductal mucinous neoplasia (IPMN) and malignant,
as in the case of cystadenocarcinoma with cystic degeneration.
According to recent studies,
in the case of CT,
a precision of 70-80% can be achieved in the differentiation of benign lesions,
while a...
Findings and procedure details
1.
CLASSIFICATION
Pancreatic cystic neoplasms can be classified either according to histological type or to morphological appearance.
(Fig.
1)
By histology:
- FREQUENT ETIOLOGIES.
Benign lesions may have either non-tumor / inflammatory-postraumatic origin (pseudocyst) or neoplastic (SCN).
Among premalignant lesions we have IPMN intraductal papillary mucinous neoplasm (IPMN) and mucinous cystic neoplasm (MCN).
Categorized as malignant tumors are those with cystic degeneration,
being adenocarcinoma the most frequent.
- UNCOMMON ETIOLOGIES.
· Epithelial pseudopapillary solid neoplasm (PSN),
with both solid and cystic component.
· Others infrequent...
Conclusion
Up to 2% of abdominal CT studies report the existence of a pancreatic cystic lesion,
often incidentally found.
This is also the case of our hospital (Fig.
26).
To achieve a diagnosis and prove the existence of a cystic neoplasia,
we should not only be familiar with the imaging hallmark features of each lesion,
but also recognize warning signs of malignancy.
Thus,
it will be essential to know the imaging methods available,
and their advantages and limitations.
A correct characterization will not only save patients...
References
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Buerke,...