Diagnostic Ultrasound - Abdomen and Pelvis
Share Embed Flag
Download ePaper

Diagnostic Ultrasound - Abdomen and Pelvis

powerstage
09.07.2019 Views

Mucinous Cystic Pancreatic Tumor (Left) Transverse transabdominal ultrasound shows a well-defined, anechoic, cystic lesion in the body of the pancreas with a few hyperechoic peripheral foci ſt. Note the normal pancreas st. (Right) Corresponding axial CECT shows an oval, cystic mass in the body of the pancreas with an enhancing capsule st. The lesion contained internal septations not seen on CT. Diagnoses: Pancreas (Left) Coronal CECT demonstrates a wellcircumscribed, round cystic mass in the tail of the pancreas with subtle internal septations ſt. (Right) Corresponding endoscopic ultrasound demonstrates a large cystic mass with internal septations ſt and a small mural nodule (calipers), which was not well seen on CT. (Left) Axial CECT shows a wellcircumscribed, rounded, cystic mass in the tail of the pancreas with subtle enhancing internal septations st. (Right) Endoscopic ultrasound demonstrates a well-defined, multilocular cystic lesion in the tail of the pancreas with internal septations ſt. 369

Serous Cystadenoma of Pancreas Diagnoses: Pancreas TERMINOLOGY • Synonyms: Pancreatic serous cystic neoplasm (SCN), microcystic adenoma of pancreas IMAGING • 2 morphologic types based on WHO subclassification ○ Serous microcystic adenoma: sponge-like/ honeycomb or polycystic mass with central scar ○ Serous oligocystic adenoma / macrocystic variant: unilocular or with a few large cysts (less common) • US: Nonspecific, solid echogenic appearance due to numerous interfaces between small cysts • CT: Better characterization of classic honeycomb pattern ○ Cluster of > 6 cysts; each typically < 1-2 cm ○ Coalescing enhancing septa → central scar ± calcification ○ May mimic solid mass • MR: Can better identify T2-hyperintense cysts separated by T2-hypointense septa KEY FACTS • EUS: May allow for presumptive diagnosis based on typical features TOP DIFFERENTIAL DIAGNOSES • Pancreatic pseudocyst • Mucinous cystadenoma of pancreas • Intraductal papillary mucinous neoplasm (IPMN) • Cystic neuroendocrine tumor • Ductal pancreatic carcinoma CLINICAL ISSUES • Commonly seen in elderly women, termed "grandmother lesion" • Typically benign and slow-growing; (nearly) no malignant potential DIAGNOSTIC CHECKLIST • Well-demarcated, microcystic lesion with a central scar in an asymptomatic elderly woman (Left) Graphic shows a spongelike or honeycombed mass in the pancreatic head. Note presence of innumerable small cysts and central scar. The pancreatic duct (PD) is not obstructed. (Right) Transverse transabdominal ultrasound shows a well-circumscribed, solid-appearing mass in the body of the pancreas, containing tiny microcysts ſt and larger peripheral cystic components st. (Courtesy A. Kamaya, MD.) (Left) Transverse transabdominal ultrasound shows a hyperechoic, solidappearing mass in the head of the pancreas with small cystic components st of varying sizes and thin intervening septa ſt. (Right) Corresponding axial CECT image in the same patient better demonstrates the mass composed of numerous clustered small cysts separated by thin enhancing septa st. 370

Serous Cystadenoma of Pancreas<br />

Diagnoses: Pancreas<br />

TERMINOLOGY<br />

• Synonyms: Pancreatic serous cystic neoplasm (SCN),<br />

microcystic adenoma of pancreas<br />

IMAGING<br />

• 2 morphologic types based on WHO subclassification<br />

○ Serous microcystic adenoma: sponge-like/ honeycomb or<br />

polycystic mass with central scar<br />

○ Serous oligocystic adenoma / macrocystic variant:<br />

unilocular or with a few large cysts (less common)<br />

• US: Nonspecific, solid echogenic appearance due to<br />

numerous interfaces between small cysts<br />

• CT: Better characterization of classic honeycomb pattern<br />

○ Cluster of > 6 cysts; each typically < 1-2 cm<br />

○ Coalescing enhancing septa → central scar ± calcification<br />

○ May mimic solid mass<br />

• MR: Can better identify T2-hyperintense cysts separated by<br />

T2-hypointense septa<br />

KEY FACTS<br />

• EUS: May allow for presumptive diagnosis based on typical<br />

features<br />

TOP DIFFERENTIAL DIAGNOSES<br />

• Pancreatic pseudocyst<br />

• Mucinous cystadenoma of pancreas<br />

• Intraductal papillary mucinous neoplasm (IPMN)<br />

• Cystic neuroendocrine tumor<br />

• Ductal pancreatic carcinoma<br />

CLINICAL ISSUES<br />

• Commonly seen in elderly women, termed "gr<strong>and</strong>mother<br />

lesion"<br />

• Typically benign <strong>and</strong> slow-growing; (nearly) no malignant<br />

potential<br />

DIAGNOSTIC CHECKLIST<br />

• Well-demarcated, microcystic lesion with a central scar in an<br />

asymptomatic elderly woman<br />

(Left) Graphic shows a spongelike<br />

or honeycombed mass in<br />

the pancreatic head. Note<br />

presence of innumerable small<br />

cysts <strong>and</strong> central scar. The<br />

pancreatic duct (PD) is not<br />

obstructed. (Right) Transverse<br />

transabdominal ultrasound<br />

shows a well-circumscribed,<br />

solid-appearing mass in the<br />

body of the pancreas,<br />

containing tiny microcysts ſt<br />

<strong>and</strong> larger peripheral cystic<br />

components st. (Courtesy A.<br />

Kamaya, MD.)<br />

(Left) Transverse<br />

transabdominal ultrasound<br />

shows a hyperechoic, solidappearing<br />

mass in the head of<br />

the pancreas with small<br />

cystic components st of<br />

varying sizes <strong>and</strong> thin<br />

intervening septa ſt. (Right)<br />

Corresponding axial CECT<br />

image in the same patient<br />

better demonstrates the mass<br />

composed of numerous<br />

clustered small cysts <br />

separated by thin enhancing<br />

septa st.<br />

370

logo

products

Resources

Company

Terms of service
Privacy policy
Cookie policy
Cookie settings
Imprint
Change language
Made with love in Switzerland
© 2024 Yumpu.com all rights reserved

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!