Intraductal Papillary-Mucinous Tumors of the Pancreas: Differential Diagnosis Between Benign and Malignant Tumors by Endoscopic Ultrasonography

Abstract

Main duct type tumors with > or =10 mm dilated MPD, branch duct type tumors (>40 mm) with irregular septa, and large mural nodules (>10 mm) strongly suggest malignancy on EUS. EUS would be a useful modality for differentiating between benign and malignant IPMT.

Incidence of Synchronous and Metachronous Pancreatic Carcinoma in 168 Patients with Branch Duct Intraductal Papillary Mucinous Neoplasm

“…The imaging diagnosis of BD-IPMN is usually made using CT and MRCP in combination with EUS or ERCP [10,11,16,17,18]. EUS is an especially accurate tool for differentiating BD-IPMN lesions from other cystic pancreatic lesions; EUS has a 92% diagnostic accuracy and permits adequate diagnosis of the presence, size, and extent of BD-IPMN.…”

“…BD-IPMNs were diagnosed based on the pathognomonic findings of ERP, i.e. a dilated cyst greater than 10 mm in diameter [6], communication between the cyst and the main pancreatic duct (MPD), and the presence of mucin, as indicated by filling defects in the pancreatic duct [16,17]. Patients who did not undergo ERP were excluded from this study.…”

Positron emission tomography with 2-deoxy-2-[ 18 F] fluoro-d-glucose for diagnosis of intraductal papillary mucinous tumor of the pancreas with parenchymal invasion

“…7,8 That is, in comparison to tumor involving the branches, tumor involving the main duct is usually associated with greater progression of histological features. Kubo et al 9 showed the diameters of the dilated ducts to be significant in the diagnosis of IPMT. They showed both a main pancreatic duct tumor with the duct dilated to 10mm or more in diameter and a branch pancreatic duct tumor (Ͼ40 mm) with irregular thick septa to be associated with malignancy.…”

Radiologische Diagnostik der intraduktalen papillär muzinösen Neoplasie

“…Die EUS hat in erfahrenen Händen eine hohe Bedeutung, da sie im Vergleich zu den Schnittbildverfahren eine höhere räumliche Auflösung bietet und auch als sensitiver im Nachweis muraler Knoten gilt [13]. Der entscheidende Vorteil liegt in der Möglichkeit, Feinnadelaspirationen vorzunehmen und das gewonnene Material zytologisch zu untersuchen, die Konzentration von Tumormarkern zu bestimmen oder molekulare Untersuchungen vorzunehmen [3].…”