Choonpa Igaku
Online ISSN : 1881-9311
Print ISSN : 1346-1176
ISSN-L : 1346-1176
REVIEW ARTICLES
Macroscopic findings and ultrasound differential diagnosis of pancreatic cystic lesions
Shinji OKANIWAKazuhiro IWASHITA
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2017 Volume 44 Issue 3 Pages 235-244

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Abstract
Pancreatic lesions are generally classified as solid or cystic lesions. Solid neoplasms include pancreatic ductal carcinoma, neuroendocrine tumor (NET), solid pseudopapillary neoplasm (SPN), and tumor-forming pancreatitis. Cystic neoplasms include serous cystic neoplasm (SCN), mucinous cystic neoplasm (MCN), and intraductal papillary mucinous neoplasm (IPMN). As ultrasound (US) reflects macroscopic pathological findings precisely, we should acknowledge the characteristic structures of each type of pancreatic cystic lesion, such as the honeycomb structure of SCN, the cyst-in-cyst structure of MCN, and the cyst-by-cyst structure of IPMN, to make correct diagnoses. Their location, number, contour, internal structure, internal echo texture, communication with MPD, and presence of solid components are useful US findings to make differential diagnoses. The presence of solid components is related to the malignant potential of cystic lesions. We also emphasize pancreatic cysts that are more than 5 mm in size as a high-risk sign for pancreatic carcinoma and recommend regular follow-up for early detection of pancreatic ductal carcinoma.
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© 2017 The Japan Society of Ultrasonics in Medicine
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