Pancreatic Mass Due to Chronic Pancreatitis
Correlation of CT and MR Imaging Features with Pathologic Findings
Tonsok Kim1,
Takamichi Murakami1,
Manabu Takamura1,
Masatoshi Hori1,
Satoru Takahashi1,
Shoji Nakamori2,
Masato Sakon2,
Yoshio Tanji3,
Kenji Wakasa4 and
Hironobu Nakamura1
1
Department of Radiology, D1, Osaka University Medical School. 2-2 Yamadaoka,
Suita City, Osaka 565-0871, Japan.
2
Department of Surgery and Clinical Oncology, Osaka University Medical School,
2-2 Yamadaoka, Suita City, Osaka 565-0871, Japan.
3
Department of Surgical Oncology, Osaka University Medical School, Suita City,
Osaka 565-0871, Japan.
4
Department of Pathology, Osaka City University Medical School, Suita City,
Osaka 565-0871, Japan.
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Fig. 1A. —69-year-old woman with mass in pancreatic head who had
metallic stent inserted at another hospital for obstruction of common bile
duct. Unenhanced CT scan of pancreatic mass (thick arrow) in
pancreatic head shows central calcification and compression of duodenum and
metallic stent (thin arrow) in common bile duct.
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Fig. 1B. —69-year-old woman with mass in pancreatic head who had
metallic stent inserted at another hospital for obstruction of common bile
duct. Pancreatic phase helical CT scan shows hypoenhanced mass (thick
arrow) relative to nonenlarged portion of pancreas (thin arrow).
Demarcation between mass and nonenlarged portion of pancreas is visible.
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Fig. 1C. —69-year-old woman with mass in pancreatic head who had
metallic stent inserted at another hospital for obstruction of common bile
duct. T2-weighted spin-echo MR image (TR/TE, 2000/80) reveals hypointense mass
(thick arrow) relative to nonenlarged portion of pancreatic head
(thin arrow).
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Fig. 1D. —69-year-old woman with mass in pancreatic head who had
metallic stent inserted at another hospital for obstruction of common bile
duct. Pancreatic phase image of dynamic MR imaging (6.2/1.4; flip angle,
40°) shows hypoenhanced mass (thick arrow) relative to
nonenlarged portion of pancreatic head (thin arrow).
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Fig. 1E. —69-year-old woman with mass in pancreatic head who had
metallic stent inserted at another hospital for obstruction of common bile
duct. Photomicrograph of histopathologic specimen of pancreatic mass obtained
with surgical resection shows mild fibrosis. (H and E, x2.5)
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Fig. 1F. —69-year-old woman with mass in pancreatic head who had
metallic stent inserted at another hospital for obstruction of common bile
duct. Photomicrograph of histopathologic specimen of pancreatic parenchyma
away from mass shows no fibrosis. (H and E, x2.5)
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Fig. 2A. —63-year-old woman with mass due to chronic pancreatitis in
pancreatic body and tail. Pancreatic phase helical CT scan shows mass
(thick arrow) in pancreatic body, which is hypoenhanced relative to
pancreatic head (thin arrow). Demarcation between mass and pancreatic
head is visible.
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Fig. 2B. —63-year-old woman with mass due to chronic pancreatitis in
pancreatic body and tail. Photomicrograph of histopathologic specimen of mass
obtained with percutaneous biopsy shows severe fibrosis. (H and E,
x50)
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Fig. 3A. —63-year-old man with pancreatic mass in pancreatic head and
dilatation of common bile duct and main pancreatic duct. Pancreatic phase
helical CT scan of pancreatic body and tail shows dilated main pancreatic duct
(arrow).
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Fig. 3B. —63-year-old man with pancreatic mass in pancreatic head and
dilatation of common bile duct and main pancreatic duct. Pancreatic phase
helical CT scan of mass in pancreatic head shows isoenhancement relative to
pancreatic body and tail so that mass is not visibly demarcated.
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Fig. 3C. —63-year-old man with pancreatic mass in pancreatic head and
dilatation of common bile duct and main pancreatic duct. Photomicrograph of
histopathologic specimen of mass obtained with surgical resection shows mild
fibrosis. (H and E, x2.5)
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Fig. 3D. —63-year-old man with pancreatic mass in pancreatic head and
dilatation of common bile duct and main pancreatic duct. Photomicrograph of
histopathologic specimen of pancreatic parenchyma other than mass also shows
mild fibrosis. (H and E, x2.5)
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