The aim of this article is to clarify diagnostic pitfalls of pancreatic serous cystic neoplasm(SCN) that may result in erroneous characterization. Usual and unusual imaging findings of SCN as well as potential SCN mim...The aim of this article is to clarify diagnostic pitfalls of pancreatic serous cystic neoplasm(SCN) that may result in erroneous characterization. Usual and unusual imaging findings of SCN as well as potential SCN mimickers are presented. The diagnostic key of SCN is to look for a cluster of microcysts(honeycomb pattern), which may not be always found in the center. Fibrosis in SCN may be mistaken for a mural nodule of intraductal papillary mucinous neoplasm(IPMN). The absence of cyst wall enhancement may be helpful to distinguish SCN from mucinous cystic neoplasm. However, oligocystic SCN and branch duct type IPMN may morphologically overlap. In addition, solid serous adenoma, an extremely rare variant of SCN, is difficult to distinguish from neuroendocrine tumor.展开更多
Pancreatic cystic lesions are increasingly identified on routine imaging.One specific lesion,known as intraductal papillary mucinous neoplasm(IPMN),is a mucinous,pancreatic lesion characterized by papillary cells proj...Pancreatic cystic lesions are increasingly identified on routine imaging.One specific lesion,known as intraductal papillary mucinous neoplasm(IPMN),is a mucinous,pancreatic lesion characterized by papillary cells projecting from the pancreatic ductal epithelium.The finding of mucin extruding from the ampulla is essentially pathognomonic for diagnosing these lesions.IPMNs are of particular interest due to their malignant potential.Lesions range from benign,adenomatous growths to highgrade dysplasia and invasive cancer.These mucinous lesions therefore require immediate attention to determine the probability of malignancy and whether observation or resection is the best management choice.Unresected lesions need long-term surveillance monitoring for malignant transformation.The accurate diagnosis of these lesions is particularly challenging due to the substantial similarities in morphology of pancreatic cystic lesions and limitations in current imaging technologies.Endoscopic evaluation of these lesions provides additional imaging,molecular,and histologic data to aid in the identification of IPMN and to determine treatment course.The aim of this article is to focus on the diagnostic and therapeutic endoscopic approaches to IPMN.展开更多
文摘The aim of this article is to clarify diagnostic pitfalls of pancreatic serous cystic neoplasm(SCN) that may result in erroneous characterization. Usual and unusual imaging findings of SCN as well as potential SCN mimickers are presented. The diagnostic key of SCN is to look for a cluster of microcysts(honeycomb pattern), which may not be always found in the center. Fibrosis in SCN may be mistaken for a mural nodule of intraductal papillary mucinous neoplasm(IPMN). The absence of cyst wall enhancement may be helpful to distinguish SCN from mucinous cystic neoplasm. However, oligocystic SCN and branch duct type IPMN may morphologically overlap. In addition, solid serous adenoma, an extremely rare variant of SCN, is difficult to distinguish from neuroendocrine tumor.
文摘Pancreatic cystic lesions are increasingly identified on routine imaging.One specific lesion,known as intraductal papillary mucinous neoplasm(IPMN),is a mucinous,pancreatic lesion characterized by papillary cells projecting from the pancreatic ductal epithelium.The finding of mucin extruding from the ampulla is essentially pathognomonic for diagnosing these lesions.IPMNs are of particular interest due to their malignant potential.Lesions range from benign,adenomatous growths to highgrade dysplasia and invasive cancer.These mucinous lesions therefore require immediate attention to determine the probability of malignancy and whether observation or resection is the best management choice.Unresected lesions need long-term surveillance monitoring for malignant transformation.The accurate diagnosis of these lesions is particularly challenging due to the substantial similarities in morphology of pancreatic cystic lesions and limitations in current imaging technologies.Endoscopic evaluation of these lesions provides additional imaging,molecular,and histologic data to aid in the identification of IPMN and to determine treatment course.The aim of this article is to focus on the diagnostic and therapeutic endoscopic approaches to IPMN.
