DOI QR코드

DOI QR Code

Pancreatic Tumors: Emphasis on CT Findings and Pathologic Classification

  • Cho, Hee-Woo (Department of Radiology and the Research Institute of Radiological Sciences, Severance Hospital, Yonsei University College of Medicine) ;
  • Choi, Jin-Young (Department of Radiology and the Research Institute of Radiological Sciences, Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Myeong-Jin (Department of Radiology and the Research Institute of Radiological Sciences, Severance Hospital, Yonsei University College of Medicine) ;
  • Park, Mi-Suk (Department of Radiology and the Research Institute of Radiological Sciences, Severance Hospital, Yonsei University College of Medicine) ;
  • Lim, Joon-Seok (Department of Radiology and the Research Institute of Radiological Sciences, Severance Hospital, Yonsei University College of Medicine) ;
  • Chung, Yong-Eun (Department of Radiology and the Research Institute of Radiological Sciences, Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Ki-Whang (Department of Radiology and the Research Institute of Radiological Sciences, Severance Hospital, Yonsei University College of Medicine)
  • 발행 : 2011.12.01

초록

Pancreatic tumors can be classified by their morphologic features on CT. The subtypes include solid tumors, mixed cystic and solid lesions, unilocular cysts, multilocular cystic lesions, and microcystic lesions. Endoscopic US and MRI can provide detailed information for classifying pancreatic lesions. Each subtype has different kinds of tumors and malignant potential, thus the classification can be useful for a better differential diagnosis and treatment planning. For this purpose, we suggest an appropriate modified classification system by using the imaging features of pancreatic tumors with an emphasis on CT findings and illustrate various findings of typical and atypical manifestations.

키워드

참고문헌

  1. Kim SY, Lee JM, Kim SH, Shin KS, Kim YJ, An SK, et al. Macrocystic neoplasms of the pancreas: CT differentiation of serous oligocystic adenoma from mucinous cystadenoma and intraductal papillary mucinous tumor. AJR Am J Roentgenol 2006;187:1192-1198 https://doi.org/10.2214/AJR.05.0337
  2. Park MS, Kim KW, Lim JS, Lee JH, Kim JH, Kim SY, et al. Unusual cystic neoplasms in the pancreas: radiologicpathologic correlation. J Comput Assist Tomogr 2005;29:610-616 https://doi.org/10.1097/01.rct.0000172561.62810.6c
  3. Irie H, Honda H, Aibe H, Kuroiwa T, Yoshimitsu K, Shinozaki K, et al. MR cholangiopancreatographic differentiation of benign and malignant intraductal mucin-producing tumors of the pancreas. AJR Am J Roentgenol 2000;174:1403-1408 https://doi.org/10.2214/ajr.174.5.1741403
  4. Song SJ, Lee JM, Kim YJ, Kim SH, Lee JY, Han JK, et al. Differentiation of intraductal papillary mucinous neoplasms from other pancreatic cystic masses: comparison of multirowdetector CT and MR imaging using ROC analysis. J Magn Reson Imaging 2007;26:86-93 https://doi.org/10.1002/jmri.21001
  5. Sahani DV, Kadavigere R, Saokar A, Fernandez-del Castillo C, Brugge WR, Hahn PF. Cystic pancreatic lesions: a simple imaging-based classification system for guiding management. Radiographics 2005;25:1471-1484 https://doi.org/10.1148/rg.256045161
  6. Mergo PJ, Helmberger TK, Buetow PC, Helmberger RC, Ros PR. Pancreatic neoplasms: MR imaging and pathologic correlation. Radiographics 1997;17:281-301 https://doi.org/10.1148/radiographics.17.2.9084072
  7. Lee LY, Hsu HL, Chen HM, Hsueh C. Ductal adenocarcinoma of the pancreas with huge cystic degeneration: a lesion to be distinguished from pseudocyst and mucinous cystadenocarcinoma. Int J Surg Pathol 2003;11:235-239 https://doi.org/10.1177/106689690301100315
  8. Choi JY, Kim MJ, Kim JH, Kim SH, Lim JS, Oh YT, et al. Solid pseudopapillary tumor of the pancreas: typical and atypical manifestations. AJR Am J Roentgenol 2006;187:W178-186 https://doi.org/10.2214/AJR.05.0569
  9. Cohen-Scali F, Vilgrain V, Brancatelli G, Hammel P, Vullierme MP, Sauvanet A, et al. Discrimination of unilocular macrocystic serous cystadenoma from pancreatic pseudocyst and mucinous cystadenoma with CT: initial observations. Radiology 2003;228:727-733 https://doi.org/10.1148/radiol.2283020973
  10. Curry CA, Eng J, Horton KM, Urban B, Siegelman S, Kuszyk BS, et al. CT of primary cystic pancreatic neoplasms: can CT be used for patient triage and treatment? AJR Am J Roentgenol 2000;175:99-103 https://doi.org/10.2214/ajr.175.1.1750099
  11. Kawamoto S, Horton KM, Lawler LP, Hruban RH, Fishman EK. Intraductal papillary mucinous neoplasm of the pancreas: can benign lesions be differentiated from malignant lesions with multidetector CT? Radiographics 2005;25:1451-1468;discussion 1468-1470 https://doi.org/10.1148/rg.256055036
  12. Levy MJ, Clain JE. Evaluation and management of cystic pancreatic tumors: emphasis on the role of EUS FNA. Clin Gastroenterol Hepatol 2004;2:639-653 https://doi.org/10.1016/S1542-3565(04)00235-6
  13. Brugge WR. The use of EUS to diagnose cystic neoplasms of the pancreas. Gastrointest Endosc 2009;69:S203-209 https://doi.org/10.1016/j.gie.2008.12.029
  14. Choi JY, Kim MJ, Lee JY, Lim JS, Chung JJ, Kim KW, et al. Typical and atypical manifestations of serous cystadenoma of the pancreas: imaging findings with pathologic correlation. AJR Am J Roentgenol 2009;193:136-142 https://doi.org/10.2214/AJR.08.1309
  15. Shintaku M, Arimoto A, Sakita N. Serous cystadenocarcinoma of the pancreas. Pathol Int 2005;55:436-439 https://doi.org/10.1111/j.1440-1827.2005.01850.x
  16. Choi JY, Lee JM, Lee MW, Kim SJ, Choi SY, Kim JY, et al. Magnetic resonance pancreatography: comparison of two- and three-dimensional sequences for assessment of intraductal papillary mucinous neoplasm of the pancreas. Eur Radiol 2009;19:2163-2170 https://doi.org/10.1007/s00330-009-1391-9

피인용 문헌

  1. Pancreatic cystic lesions: How endoscopic ultrasound morphology and endoscopic ultrasound fine needle aspiration help unlock the diagnostic puzzle vol.4, pp.6, 2012, https://doi.org/10.4253/wjge.v4.i6.247
  2. The incidental cystic pancreas mass: a practical approach vol.12, pp.2, 2012, https://doi.org/10.1102/1470-7330.2012.9054
  3. Unusual Features in an Adult Pancreatic Hemangioma: CT and MRI Demonstration vol.14, pp.5, 2013, https://doi.org/10.3348/kjr.2013.14.5.781
  4. Ethanol Lavage Therapy to Prevent Recurrent Pancreatitis in a Patient with Pancreatic Mucinous Neoplasm vol.85, pp.5, 2013, https://doi.org/10.3904/kjm.2013.85.5.511
  5. Solid pseudopapillary tumor of pancreas: A lesser known entity-diagnosis and pitfalls: A case report vol.33, pp.4, 2011, https://doi.org/10.4103/0970-9371.190443
  6. Comparison of endoscopic ultrasound, computed tomography and magnetic resonance imaging in assessment of detailed structures of pancreatic cystic neoplasms vol.23, pp.17, 2017, https://doi.org/10.3748/wjg.v23.i17.3184
  7. Retroperitoneal Extraskeletal Osteosarcoma without Calcification Mimicking Pancreas Tumor: CT Imaging of a Case Report vol.78, pp.5, 2011, https://doi.org/10.3348/jksr.2018.78.5.340
  8. Hemosuccus pancreaticus from superior mesenteric artery pseudoaneurysm within perceived pancreatic mass vol.12, pp.1, 2011, https://doi.org/10.1007/s12328-018-0899-4
  9. Metastatic mucinous cystadenocarcinoma of the pancreas presenting as intractable back pain vol.12, pp.11, 2011, https://doi.org/10.1136/bcr-2019-230070
  10. A Prospective Study on Contrast-Enhanced Endoscopic Ultrasound for Differential Diagnosis of Pancreatic Cystic Neoplasms vol.64, pp.12, 2011, https://doi.org/10.1007/s10620-019-05718-z
  11. Comparative Diagnostic Evaluation with Contrast-Enhanced Ultrasound, Computed Tomography and Magnetic Resonance Imaging in Patients with Pancreatic Cystic Neoplasms vol.12, pp.None, 2011, https://doi.org/10.2147/cmar.s246564
  12. A case of pancreatic hamartoma with characteristic radiological findings: radiological-pathological correlation vol.45, pp.7, 2011, https://doi.org/10.1007/s00261-020-02425-6