The purpose of this educational exhibit is to describe the imaging findings of four suspected cases of hypervascular pancreatic lesions,
discussing briefly all differential diagnosis,
aiming to provide a review of the topic.
Hypervascular pancreatic lesions can have multiple causes,
and pitfalls are commonly observed .
Accurate diagnosis demand proper knowledge,
and is crucial to evaluate the need of resection,
avoiding unnecessary procedures.
The differential diagnosis consists,
of tumors (primary and metastatic) and lesions from adjacent structures,
which could mimic a pancreatic disease [1,2].
The lesions may be divided into three groups based on their risk for malignancy: “no-risk” (non-neoplastic lesions like vascular abnormalities and intrapancreatic accessory spleen),
“low risk” (solid pseudopapillary tumors...
Findings and procedure details
Intrapancreatic spleen (“no-risk” lesion)
reported to the emergency room with a chief complaint of abdominal pain.
A CT scan revealed an early arterial enhancing nodule within the pancreatic tail,
measuring 1,5 x 1,0 cm.
(Figure 1) The rest of the pancreas showed unremarkable form,
volume and density.
There was no ductal dilatation.
a biopsy confirmed the diagnosis of heterotopic splenic tissue.
An intrapancreatic spleen has increased vascularity in comparison with the surrounding pancreatic parenchyma,
the patient is often asymptomatic,
Hypervascular pancreatic lesions can be diagnostic challenging,
therefore radiologists must recognize the different forms of presentation in CT and MRI.
Radiologists play a crucial role in diagnosis,
therefore improvement in criteria and better methodology for diagnosis is necessary.
1 - Hypervascular pancreatic "lesions": a pattern-based approach to differentiation.
Abdom Radiol (NY) 2017 Oct 31 Published online 2017 Oct 31.
2 - Raman SP,
Fishman EK (2012) Pancreatic imaging mimics: part 2,
pancreatic neuroendocrine tumors and their mimics.
Am J Roentgenol 199(2):309–318.
3 - Ro C,
Yu R (2013) Pancreatic neuroendocrine tumors: biology,