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Type:
Educational Exhibit
Keywords:
Congenital, Cancer, Diagnostic procedure, Ultrasound, MR, CT, Pancreas, Oncology, Anatomy
Authors:
X. Merino Casabiel1, C. A. Ortiz Andrade2, D. Armario Bel2, E. Ramirez Pinto2, K. Ramirez Tucas2, S. Quiroga Gómez2, X. Molero2, M. T. Salcedo Allende2; 1Barcelona, BARCELONA/ES, 2Barcelona/ES
DOI:
10.1594/ecr2017/C-2408
Conclusion
Mimics of pancreatic disease,
caused by developmental variants and anomalies,
are commonly encountered on imaging studies.
To differentiate these benign “nontouch” entities from true pancreatic conditions,
radiologists should be familiar with them,
the imaging techniques available to study them,
and their variable imaging presentations.
Some neoplastic and inflammatory diseases can simulate pancreatic adenocarcinoma including neuroendocrine tumor,
metastasis to the pancreas,
lymphoma,
groove pancreatitis,
autoimmune pancreatitis,
and focal chronic pancreatitis. Differentiation between these lesions and pancreatic adenocarcinoma can be challenging,
due to the overlap in imaging features; however,
familiarity with their typical imaging features and clinical presentation may be helpful in their differentiation,
as in some cases,
invasive diagnostic tests or unnecessary surgery can be avoided.
Any lesion that is hypervascular can mimic a pancreatic NET.
Most common mimics include: intrapancreatic splenules,
serous microcystic adenoma, hypervascular metastases,
and vascular lesions such as splenic artery aneurysm or pseudoaneurysm. Clinical history,
imaging features (ductal involvement,
presence of fat plane between mass and the pancreas),
and further imaging evaluation (e.g.99mTc heat-damaged red blood cell scintigraphy for intrapancreatic splenule),
can aid in narrowing the differential diagnosis of a hypervascular mass in or adjacent to the pancreas.
Familiarity with these common mimics of pancreatic NETs can offer alternate diagnoses in certain clinical situations,
allowing appropriate treatment.