Macrocystic neoplasms of the pancreas: CT differentiation of serous oligocystic adenoma from mucinous cystadenoma and intraductal papillary mucinous tumor

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Kim, Sang Youn; Lee, Jeong Min; Kim, Se Hyung; Kim, Young Jun; An, Su Kyung; Han, Chang Jin; Han, Joon Koo; Choi, Byung Ihn
Issue Date
American Roentgen Ray Society
AJR 2006; 187:1192–1198
abdominal imagingCTintraductal papillary mucinous tumormacrocystic serous adenomamucinous cystadenomapancreaspancreaticobiliary imagingserous oligocystic adenoma
OBJECTIVE. The purpose of our study was to determine useful CT criteria for differentiating
serous oligocystic adenomas of the pancreas from other similarly presenting neoplasms, such
as mucinous cystadenoma and intraductal papillary mucinous tumor of the branch duct type.
MATERIALS AND METHODS. Forty-one patients with histologically confirmed macrocystic
neoplasms of the pancreas were enrolled: serous oligocystic adenoma in 10 patients,
mucinous cystadenoma in 13, and intraductal papillary mucinous tumor in 18. Location, greatest
dimension, shape, presence of mural nodules, presence of wall calcification, and the extent
and degree of main pancreatic duct (MPD) dilatation were analyzed with CT. The lesions were
categorized into seven groups according to their shapes: multicystic, lobulated contour with and
without internal septation, smooth contour with and without internal septation, pleomorphic
cystic, and clubbed fingerlike cystic. Comparative studies were performed using Fisher’s exact
test and the Mann-Whitney U test.
RESULTS. Significant differences in lesion shape were found between serous oligocystic
adenoma and the other macrocystic neoplasms (mucinous cystadenoma [p < 0.05], intraductal
papillary mucinous tumor [p < 0.05]). Serous oligocystic adenoma had a multicystic or lobulated
contour with or without septation, whereas mucinous cystadenoma had a smooth contour
with or without septation and intraductal papillary mucinous tumor had either a pleomorphic
or a clubbed fingerlike cystic shape. Serous oligocystic adenoma showed proximal MPD dilatation
from the lesion, whereas intraductal papillary mucinous tumor showed distal or whole
MPD dilatation (p < 0.05). No significant difference was apparent among the three diseases in
terms of location, greatest dimension, or presence of calcification or mural nodules.
CONCLUSION. Serous oligocystic adenoma of the pancreas has characteristic CT findings
that differentiate it from other cystic tumors. It appears as a multicystic or lobulated cystic
lesion with septation.
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