CT and MRI diagnosis of rare pancreatic tumors_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XIEHuan ¹ ,  YINLonglin ^1,2 , GOUWenxiao ¹ , CHENXiaoyu ² , WANGFumin ²

1. Department of Radiology, The Affiliated Hospital of Southwest Medical University, Lu Zhou, Sichuan 646000, P.R.China;
2. Department of Radiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu 610072, P.R.China;

Corresponding author：

YINLonglin, Email: yinlonglin@163.com

Keywords：

pancreatic neoplasm; diagnosis; computed tomography; magnetic resonance imaging

DOI：

10.7507/1007-9424.201609022

Video：

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Objective To investigate the CT and MR imaging manifestation of rare pancreatic tumors in order to deepen the understanding of their imaging characteristics and improve the diagnostic accuracy. Methods Clinical and image date of 34 cases with rare pancreatic tumors proved by surgery and histopathologically were analyzed retrospectively. Including neuroendocrine tumors of the pancreas (NETP,n=13), solid-pseudopapillary tumors of pancreas (SPTP,n=10), intraductal papillary mucinous neoplasms (IPMN,n=2), serous cystadenoma (SCA,n=7), and mucinous cystadenoma (MCA,n=2). Examined by CT in 19 cases, by MRI in 11 cases, examined by CT and MRI at the same time in 4 cases. The characterized imaging features of each kind of tumors were analyzed emphatically. Results Of the 13 cases of NETP, solid lesions in 6 cases, predominantly soild in 4 cases, predominantly cystic in 3 cases. Homogenous enhancement in 6 cases, heterogeneous enhancement in 7cases, the soild constituent of all cases were showed moderate to marked enhancement. Of the 10 cases of SPTP, predominantly soild in 2 cases, soild and cystic in 5 cases, predominantly cystic in 3 cases. The solid part of 10 cases presented as gradually enhancement, 2 cases appeared hemorrhage, 1 case appeared stippled calcification. Of the 2 cases of IPMN, both of them were combined type, showed multilocular cystic tumors due to the dilated of the pancreatic duct. Of the 7 cases of SCA, microcystic partten in 3 cases and single cyst partten in 4 cases, showed unilocular or multilocular cystic with clear boundary. The 2 cases of MCA, showed unilocular cystic with clear boundary. Conclusion Different histological types of pancreatic rare tumor appeared different kinds of imaging characteristic, we may improve the diagnostic accuracy by analyzing their features.

Citation： XIEHuan, YINLonglin, GOUWenxiao, CHENXiaoyu, WANGFumin. CT and MRI diagnosis of rare pancreatic tumors. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(1): 107-114. doi: 10.7507/1007-9424.201609022 Copy

1.	Pomianowska E, Gladhaug IP, Grzyb K,et al. Survival following resection of pancreatic endocrine tumors: importance of R-status and the WHO and TNM classification systems. Scand J Gastroenterol, 2010, 45(7-8): 971-979.
2.	Yao JC, Hassan M, Phan A,et al. One hundred years after “carci-noid” : epidemiology of and prognostic factors for neuroen- docrine tumors in 35 825 cases in the United States. J Clin Oncol, 2008, 26(18): 3063-3072.
3.	蒙苏, 严福华, 周康荣, 等. 非功能性胰内分泌肿瘤的螺旋CT表现. 中华放射学杂志, 2003, 37(6): 528-531.
4.	Grözinger G, Grözinger A, Horger M. The role of volume perfusion CT in the diagnosis of pathologies of the pancreas. Rofo, 2014, 186(12): 1082-1093.
5.	敖炜群, 胡金文, 曾蒙苏, 等. 高分化胰腺神经内分泌肿瘤的CT表现及与病理对照分析.中国医学计算机成像杂志, 2015, 21(2): 139-144.
6.	史玉振, 王中秋, 卢光明, 等. 胰腺神经内分泌肿瘤的影像学表现与临床病理对照分析.临床放射学杂志, 2011, 30(11): 1618-1623.
7.	Ventriglia A, Manfredi R, Mehrabi S,et al. MRI features of solid pseudopapillary neoplasm of the pancreas. Abdom Imaging, 2014, 39(6): 1213-1220.
8.	井方方, 赵君慧, 郭洋, 等. 国内胰腺实性假乳头状1180例临床荟萃分析. 中国胰腺病杂志, 2013,13(2): 98-102.
9.	王华斌, 李苏建, 卢光明. 胰腺实性-假乳头状瘤的CT和MRI表现. 中国医学影像学杂志, 2009, 17(3): 22-224.
10.	Cantisani V, Mortele KJ, Levy A,et al. MR imaging features of solid pseudopapillary tumor of the pancreasin adult and pediatric patients. AJR Am J Roentgenol, 2003, 181(2): 395-401.
11.	Choi JY, Kim MJ, Kim JH,et al. Solid pseudopapillarytumor of the pancreas: typical and atypical manifestations. AJR Am J Roentgenol, 2006, 187(2): W178-W186.
12.	Yao X, ji Y, Zeng M,et al. Solid pseudopapillary tumor of the pancreas: corss-sectional imaging and patholosic correlation. Pancreas, 2010, 39(4): 486-491.
13.	Buetow PC, Buck JL, Pantongrag-Brown L,et al. Solid and papillary epithelial neoplasm of the pancreas: imaging-pathologic correlation on 56 cases. Radiology, 1996, 199(3): 707-711.
14.	Ohtomo K, Furui S, Onoue M,et al. Solid and papillary epithlial neoplasm of the pancreas: MR imaging and pathologic corrrealation. Radiology, 1992, 184(2): 567-570.
15.	Koizumi J, Kodera K,Kaneda S,et al. Two cases of siold and cystic tumor of the pancreas (including one case of MRI). [in Japanese]. Nihon Igaku Hoshasen Gakkai Zasshi, 1990, 50(1): 56-60.
16.	Salvia R, Bassi C, Festa L,et al. Clinical and biological be-havior of pancreatic solid pseudopapillary tumors: report on31 consecutive patients. J Surg Oncol, 2007, 95 (4) : 304-310.
17.	Tanaka M. Intraductal papillary mucinous neoplasm of the pancreas: diagnosis and treatment. Pancreas, 2004, 28(3): 282-288.
18.	常晓燕, 姜英, 李霁,等. 胰腺导管内乳头状粘液性肿瘤的研究进展. 癌症进展, 2009, 7(6): 600-604.
19.	李仁峰, 王中秋, 郝楠馨, 等. 胰腺导管内乳头状黏液性肿瘤的CT及MRI表现. 实用放射学杂志, 2013, 29(2): 327-329.
20.	Kawai M, Uchiyama K, Tani M,et al. Clinicopathological features of malignant intraductalpapillary mucinous tumors of the pancreas: the differential diagnosis from benign entities. Arch Surg, 2004, 139(2): 188-192.
21.	Sugiyama M, Atomi Y. Intraductal papillary mucinous tumors of the pancreas: imaging studies and treatment strategies. Ann Surg, 1998, 228(5): 685-691.
22.	Sarr MG, Murr M, Smyrk TC,et al. Primary cystic neoplasms of the pancreas. Neoplastic disorders of emerging importance-current state-of-the-art and unanswered questions.J Gastrointest Surg, 2003, 7(3): 417-428.
23.	Colonna J, Plaza J, Frankel W,et al. Serous cystadenoma of the pancreas: clinical and pathological features in 33 patients. Pancreatology, 2008, 8(8): 135-141.
24.	Curry CA, Eng J, Horton KM,et al. CT of primary cystic pancreatic neoplasms: can CT be used for patient triage and treatment? Am J Roentgenol, 2000, 175(175): 99-103.
25.	Shah AA, Sainani NI, Ramesh AK,et al. Predictive value of multi-detector computed tomography for accurate diagnosis of serous cystadenoma: Radiologic-pathologic correlation. World J Gastroenterol, 2009, 15(22): 2739-2747.
26.	Goh BK, Tan YM, Yap WM,et al. Pancreatic serous oligocystic adenomas: clinicopathologic features and a comparison with serous microcystic adenomas and mucinous cystic neoplasms. World J Surg, 2006, 30(8): 1553-1559.

1. Pomianowska E, Gladhaug IP, Grzyb K,et al. Survival following resection of pancreatic endocrine tumors: importance of R-status and the WHO and TNM classification systems. Scand J Gastroenterol, 2010, 45(7-8): 971-979.
2. Yao JC, Hassan M, Phan A,et al. One hundred years after “carci-noid” : epidemiology of and prognostic factors for neuroen- docrine tumors in 35 825 cases in the United States. J Clin Oncol, 2008, 26(18): 3063-3072.
3. 蒙苏, 严福华, 周康荣, 等. 非功能性胰内分泌肿瘤的螺旋CT表现. 中华放射学杂志, 2003, 37(6): 528-531.
4. Grözinger G, Grözinger A, Horger M. The role of volume perfusion CT in the diagnosis of pathologies of the pancreas. Rofo, 2014, 186(12): 1082-1093.
5. 敖炜群, 胡金文, 曾蒙苏, 等. 高分化胰腺神经内分泌肿瘤的CT表现及与病理对照分析.中国医学计算机成像杂志, 2015, 21(2): 139-144.
6. 史玉振, 王中秋, 卢光明, 等. 胰腺神经内分泌肿瘤的影像学表现与临床病理对照分析.临床放射学杂志, 2011, 30(11): 1618-1623.
7. Ventriglia A, Manfredi R, Mehrabi S,et al. MRI features of solid pseudopapillary neoplasm of the pancreas. Abdom Imaging, 2014, 39(6): 1213-1220.
8. 井方方, 赵君慧, 郭洋, 等. 国内胰腺实性假乳头状1180例临床荟萃分析. 中国胰腺病杂志, 2013,13(2): 98-102.
9. 王华斌, 李苏建, 卢光明. 胰腺实性-假乳头状瘤的CT和MRI表现. 中国医学影像学杂志, 2009, 17(3): 22-224.
10. Cantisani V, Mortele KJ, Levy A,et al. MR imaging features of solid pseudopapillary tumor of the pancreasin adult and pediatric patients. AJR Am J Roentgenol, 2003, 181(2): 395-401.
11. Choi JY, Kim MJ, Kim JH,et al. Solid pseudopapillarytumor of the pancreas: typical and atypical manifestations. AJR Am J Roentgenol, 2006, 187(2): W178-W186.
12. Yao X, ji Y, Zeng M,et al. Solid pseudopapillary tumor of the pancreas: corss-sectional imaging and patholosic correlation. Pancreas, 2010, 39(4): 486-491.
13. Buetow PC, Buck JL, Pantongrag-Brown L,et al. Solid and papillary epithelial neoplasm of the pancreas: imaging-pathologic correlation on 56 cases. Radiology, 1996, 199(3): 707-711.
14. Ohtomo K, Furui S, Onoue M,et al. Solid and papillary epithlial neoplasm of the pancreas: MR imaging and pathologic corrrealation. Radiology, 1992, 184(2): 567-570.
15. Koizumi J, Kodera K,Kaneda S,et al. Two cases of siold and cystic tumor of the pancreas (including one case of MRI). [in Japanese]. Nihon Igaku Hoshasen Gakkai Zasshi, 1990, 50(1): 56-60.
16. Salvia R, Bassi C, Festa L,et al. Clinical and biological be-havior of pancreatic solid pseudopapillary tumors: report on31 consecutive patients. J Surg Oncol, 2007, 95 (4) : 304-310.
17. Tanaka M. Intraductal papillary mucinous neoplasm of the pancreas: diagnosis and treatment. Pancreas, 2004, 28(3): 282-288.
18. 常晓燕, 姜英, 李霁,等. 胰腺导管内乳头状粘液性肿瘤的研究进展. 癌症进展, 2009, 7(6): 600-604.
19. 李仁峰, 王中秋, 郝楠馨, 等. 胰腺导管内乳头状黏液性肿瘤的CT及MRI表现. 实用放射学杂志, 2013, 29(2): 327-329.
20. Kawai M, Uchiyama K, Tani M,et al. Clinicopathological features of malignant intraductalpapillary mucinous tumors of the pancreas: the differential diagnosis from benign entities. Arch Surg, 2004, 139(2): 188-192.
21. Sugiyama M, Atomi Y. Intraductal papillary mucinous tumors of the pancreas: imaging studies and treatment strategies. Ann Surg, 1998, 228(5): 685-691.
22. Sarr MG, Murr M, Smyrk TC,et al. Primary cystic neoplasms of the pancreas. Neoplastic disorders of emerging importance-current state-of-the-art and unanswered questions.J Gastrointest Surg, 2003, 7(3): 417-428.
23. Colonna J, Plaza J, Frankel W,et al. Serous cystadenoma of the pancreas: clinical and pathological features in 33 patients. Pancreatology, 2008, 8(8): 135-141.
24. Curry CA, Eng J, Horton KM,et al. CT of primary cystic pancreatic neoplasms: can CT be used for patient triage and treatment? Am J Roentgenol, 2000, 175(175): 99-103.
25. Shah AA, Sainani NI, Ramesh AK,et al. Predictive value of multi-detector computed tomography for accurate diagnosis of serous cystadenoma: Radiologic-pathologic correlation. World J Gastroenterol, 2009, 15(22): 2739-2747.
26. Goh BK, Tan YM, Yap WM,et al. Pancreatic serous oligocystic adenomas: clinicopathologic features and a comparison with serous microcystic adenomas and mucinous cystic neoplasms. World J Surg, 2006, 30(8): 1553-1559.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

CT and MRI diagnosis of rare pancreatic tumors

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