Purpose: We aimed to study the characteristic findings of pancreatic metastatic tumors on transabdominal ultrasound images.

Subjects and Methods: We reviewed 32 patients who underwent transabdominal ultrasound and were histologically diagnosed with pancreatic metastatic tumor. The ultrasound findings were retrospectively analyzed. Differences in ultrasound findings according to the primary site were also reviewed.

Results and Discussion: Major ultrasound findings from the 27 cases that could be visualized were as follows: clear and smooth or rough contour in 22 cases (81%), homogenous in 23 cases (85%), and hypoechoic echotexture in 18 cases (67%). Marginal hypoechoic zone, cystic component, blood flow signal, and hyperechoic spots were found in approximately half of the tumors, but are also seen in other pancreatic solid tumors, making it challenging to distinguish between them. In contrast, in cases of renal cell carcinoma (12 cases), marginal hypoechoic zone and blood flow signal were frequently observed [in 11 cases (92%) and 10 cases (83%), respectively].

Conclusion: In this study, it was challenging to identify specific ultrasound findings of pancreatic metastatic tumors because of the variety of primary sites and small number of cases. However, intratumoral blood flow signal and marginal hypoechoic zone were commonly seen and were thought to be distinctive findings in cases of renal cell carcinoma.

Over the past two decades at this hospital, five cardiac malignant lymphoma cases were encountered. All five cases were diagnosed as diffuse large B-cell lymphoma (DLBCL), and all of these cardiac tumors were initially detected by chest computed tomography. Moreover, solitary cardiac tumors were found in two cases. The tumor was located in the interventricular septum in one case and on the right atrium’s free wall side in four cases. In one of these four cases, the tumor was located on the whole right heart’s free wall, involving the posterior leaflet of the tricuspid valve. DLBCL was diagnosed by right ethmoid sinus tumor biopsy in one case, transthoracic echocardiography (TTE)-guided biopsy in two cases, intracardiac echocardiography (ICE)-guided biopsy in one case, and open chest biopsy due to technical difficulty with TTE- or ICE-guided biopsy in one case. TTE showed decreased tumor sizes due to chemotherapy in all cases. After the initial diagnosis, the patients succumbed between 7 months to 5.7 years (average 2.8 years) in four of the five cases, while in the remaining case; the patient has been alive for 10 years. Cardiac malignant lymphomas often shrink markedly due to chemotherapy, and patients with cardiac malignant lymphoma are expected to have a long-term prognosis. TTE is useful for cardiac malignant lymphoma detection and follow-up of its size after chemotherapy initiation. Biopsy for definitive diagnosis is necessary to start appropriate chemotherapy and echocardiography, including TTE and ICE, is useful for biopsy guidance.