Macrocystic Neoplasms of the Pancreas: CT Differentiation of Serous Oligocystic Adenoma from Mucinous Cystadenoma and Intraductal Papillary Mucinous Tumor
Sang Youn Kim1,
Jeong Min Lee1,
Se Hyung Kim1,
Kyung-Sook Shin1,2,
Young Jun Kim1,
Su Kyung An1,
Chang Jin Han1,
Joon Koo Han1 and
Byung Ihn Choi1
1 Department of Radiology and Institute of Radiation Medicine, Seoul National
University Hospital and College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul
110-744, Korea.
2 Present address: Department of Radiology, Chungnam National University
Hospital, Seoul, Korea.
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Fig. 1A —Schematic diagrams of shapes of cystic lesions.
"Multicystic shape" was defined as conglomeration of two or more
round cysts. We defined a cyst as a simple closed curve without concavity to
differentiate it from an internal locule in septate shape.
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Fig. 1B —Schematic diagrams of shapes of cystic lesions.
"Lobulated shape with septation" was defined as a septate simple
closed curve that cannot be described as borders of the same circle.
"Internal locule" was defined as an angular closed curve without
protrusion from border of a primary lesion.
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Fig. 1C —Schematic diagrams of shapes of cystic lesions.
"Lobulated shape without septation" was defined as a nonseptate
simple closed curve that cannot be described as borders of the same
circle.
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Fig. 1D —Schematic diagrams of shapes of cystic lesions. "Smooth
shape with septation" was defined as a septate simple closed curve with
borders of the same circle and internal septation.
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Fig. 1E —Schematic diagrams of shapes of cystic lesions. "Smooth
shape without septation" was defined as a nonseptate simple closed curve
with borders of the same circle.
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Fig. 1F —Schematic diagrams of shapes of cystic lesions.
"Pleomorphic cystic shape" was defined as composed of three or
more cysts that include more than one oval or tubular cyst. We defined a
"tubular" or "oval" cyst as one having a conic
section, the plane of which was not parallel to axis, base, or generatrix of
the intersected cone.
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Fig. 1G —Schematic diagrams of shapes of cystic lesions.
"Clubbed fingerlike cystic shape" was defined as one containing
one or two cysts with a tubular or oval shape.
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Fig. 2 —Serous oligocystic adenoma of pancreas in 49-year-old man.
Contrast-enhanced CT scan obtained during portal venous phase shows
multicystic shaped cystic mass (arrow) in neck of pancreas. Proximal
main pancreatic duct dilatation was also noted.
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Fig. 3A —Serous oligocystic adenoma of pancreas in 34-year-old woman.
Contrast-enhanced CT scans obtained during portal venous phase show lobulated
cystic mass in head of pancreas (white arrow, B). Mass has
many internal locules and subtle enhancing septa (black arrow,
B). Proximal main pancreatic duct dilatation (arrowhead,
A) is also noted.
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Fig. 3B —Serous oligocystic adenoma of pancreas in 34-year-old woman.
Contrast-enhanced CT scans obtained during portal venous phase show lobulated
cystic mass in head of pancreas (white arrow, B). Mass has
many internal locules and subtle enhancing septa (black arrow,
B). Proximal main pancreatic duct dilatation (arrowhead,
A) is also noted.
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Fig. 4 —Mucinous cystadenoma of pancreas in 46-year-old woman.
Contrast-enhanced CT scan obtained during pancreatic phase shows smooth cyst
mass in tail of pancreas (white arrow). Mass has many internal
locules with septa (black arrow).
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Fig. 5A —Branch duct type intraductal papillary mucinous tumor of
pancreas in 65-year-old man. Contrast-enhanced CT scans obtained during
pancreatic (A) and portal venous (B) phases show grapelike
cystic mass in head of pancreas (arrow, A). Mass contains
variable cysts such as oval and tubular cysts (arrows, B) and
is of typical pleomorphic cystic shape.
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Fig. 5B —Branch duct type intraductal papillary mucinous tumor of
pancreas in 65-year-old man. Contrast-enhanced CT scans obtained during
pancreatic (A) and portal venous (B) phases show grapelike
cystic mass in head of pancreas (arrow, A). Mass contains
variable cysts such as oval and tubular cysts (arrows, B) and
is of typical pleomorphic cystic shape.
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Fig. 5C —Branch duct type intraductal papillary mucinous tumor of
pancreas in 65-year-old man. Maximum-intensity-projection image reconstructed
in coronal plane shows variable cysts (arrow) and whole main
pancreatic duct dilatation (arrowhead).
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Fig. 6A —Branch duct type intraductal papillary mucinous tumor of
pancreas in 64-year-old man. Contrast-enhanced CT scans obtained during
pancreatic phase show clubbed fingerlike cystic mass in tail of pancreas
(arrow, A). Dilatation of entire main pancreatic duct
(arrowhead, B) was also noted.
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Fig. 6B —Branch duct type intraductal papillary mucinous tumor of
pancreas in 64-year-old man. Contrast-enhanced CT scans obtained during
pancreatic phase show clubbed fingerlike cystic mass in tail of pancreas
(arrow, A). Dilatation of entire main pancreatic duct
(arrowhead, B) was also noted.
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Copyright © 2006 by the American Roentgen Ray Society.
