Learning Objectives
To review the imaging findings of cystic pancreatic lesions.
To describe an imaging based classification of cystic pancreatic lesions.
To present an algorithmic approach to the management of these lesions.
Background
Cystic pancreatic lesions have a diverse morphology and range from benign to malignant in nature.
It is important to be familiar with their imaging features and characteristics on different modalities in order to be able to guide appropriate management.
Particularly so since pancreatic surgery carries high morbidity,
it is important to be familiar with the imaging features of benign lesions that can be followed up on a regular basis versus potential malignant lesions that need surgical attention.
The management of small incidentally discovered pancreatic cystic...
Imaging Findings OR Procedure Details
METHODS:
The radiologic information at Royal Perth Hospital was searched for the terms “pancreas” or “pancreatic” and “cyst” on CT abdomen or MRI reports between 1/08/2011 and 1/2/2012.
Imaging findings were correlated with histopathology when available.
RESULTS:
A total of 32 patients were identified with pancreatic cystic lesions on imaging.
12 had simple cysts (i.e no prior history of pancreatitis,
unilocular with smooth wall and no solid component) and
6 had pseudocysts (i.e prior history of pancreatitis)
The remainder 14 had features consistent with cystic...
Conclusion
CT and MRCP are excellent modalities for initial diagnosis of pancreatic cystic lesions with endoscopic ultrasound (and aspiration biopsy) reserved for further characterization of such lesions if needed.
References
Khan A,
Khosa F,
Eisenberg RL.Cystic lesions of the pancreas.
AJR Am J Roentgenol.2011;196(6):W668-77.
S M M de Castro,J T Houwert,
N A van der Gaag,
T M van Gulik,
O R C Busch,
D J Gouma.
Evaluation of a selective management strategy of patients with primary cystic neoplasms of the pancreas.
Int J Surg.
2011;9(8):655-8.
Lahat G,
Lubezky N,
Haim MB et al.
Cystic tumors of the Pancreas: High Malignant Potential.
IMAJ 2011;13:284-289.
Sahani DV,
Kadavigere R,
Saokar A,
Fernandez-del Castillo C,
Brugge WR,...