Intraductal Papillary Mucinous Tumors of the Pancreas
Thin-Section Helical CT Findings
Yoshihiko Fukukura1,
Fumito Fujiyoshi1,
Michiro Sasaki1,
Hiroki Inoue1,
Suguru Yonezawa2 and
Masayuki Nakajo1
1
Department of Radiology, Faculty of Medicine, Kagoshima University, 8-35-1
Sakuragaoka, Kagoshima City, 890-8520, Japan.
2
Department of Second Pathology, Faculty of Medicine, Kagoshima University,
Kagoshima City, 890-8520, Japan.
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Fig. 1A. —68-year-old man with benign intraductal papillary mucinous tumor.
Helical CT scan shows papilla (arrowheads) bulging into duodenal
lumen (straight arrows). Note that papilla is contiguous with main
pancreatic duct (curved arrow).
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Fig. 2A. —75-year-old man with malignant intraductal papillary mucinous tumor.
Helical CT scan shows dilatation of main pancreatic duct (arrow).
Pancreatic parenchyma is markedly atrophic.
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Fig. 1B. —68-year-old man with benign intraductal papillary mucinous tumor.
Helical CT scan shows multilocular cystic lesion (arrowheads) without
papillary projections in uncinate process.
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Fig. 3A. —71-year-old woman with benign intraductal papillary mucinous tumor
with 2-mm papillary neoplasms. Helical CT scan shows multilocular cystic
lesion communicating with main pancreatic duct (arrow) in pancreatic
tail. Papillary projections corresponding to 2-mm papillary neoplasms in
cystic lesion are not seen.
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Fig. 4. —65-year-old man with malignant intraductal papillary mucinous tumor.
Helical CT scan shows unilocular cystic lesion (arrowhead) in
pancreatic head. Communication between dilated main pancreatic duct
(arrow) and cystic lesion is equivocal. It is difficult to
differentiate intraductal papillary mucinous tumor from other cystic
diseases.
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Fig. 3B. —71-year-old woman with benign intraductal papillary mucinous tumor
with 2-mm papillary neoplasms. Endoscopic retrograde pancreatogram shows
slightly dilated main pancreatic duct and simultaneous opacification of cystic
lesion in pancreatic tail.
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Fig. 1D. —68-year-old man with benign intraductal papillary mucinous tumor.
Histologic specimen shows communication (straight arrow) between main
pancreatic duct (curved arrow) and cystic lesion (arrowhead)
covered by papillary epithelium smaller than 1 mm. (H and E, x1)
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Fig. 1C. —68-year-old man with benign intraductal papillary mucinous tumor.
Helical CT scan obtained at level directly below that of B shows
communication (straight arrow) between dilated main pancreatic duct
(curved arrow) and cystic lesion (arrowhead).
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Fig. 2C. —75-year-old man with malignant intraductal papillary mucinous tumor.
Photograph of excised specimen corresponding to B shows dilated main
pancreatic duct filled with 8-mm papillary neoplasms.
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Fig. 2B. —75-year-old man with malignant intraductal papillary mucinous tumor.
Helical CT scan shows papillary neoplasms (arrowheads) as slightly
heterogeneous soft tissue in dilated pancreatic duct. Invasive carcinoma in
pancreatic parenchyma is not seen.
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Fig. 2D. —75-year-old man with malignant intraductal papillary mucinous tumor.
Photomicrograph of histologic specimen corresponding to B and C
shows invasive adenocarcinoma components (arrows) in pancreatic
parenchyma. (H and E, x5)
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Copyright © 2000 by the American Roentgen Ray Society.
