MRI features of solid pseudopapillary neoplasm of the pancreas

Abstract

MR imaging features can be highly suggestive for the diagnosis of SPN.

Solid Pseudopapillary Neoplasms of the Pancreas: a 19-Year Multicenter Experience in China

“…15 MRI is better than CT in differentiating the cystic or solid component inside the tumor and providing information about resectability. 16 The use of fine-needle aspiration cytology (FNAC) either percutaneously or EUS guided can help distinguish SPNs from other pancreatic tumors. 17 However, seeding of the needle tract by neoplastic cells and complications, such as bleeding, pancreatic fistula, and biliary fistula during the procedure, also had been reported.…”

Radiological Workup of Cystic Neoplasms of the Pancreas

“…Small SPNs show predominantly solid sheets of cells with ample cytoplasm and degenerative changes. Larger lesions often have a combination of solid, cystic, and pseudopapillary tissue patterns as well as intratumoral hemorrhage [44,45,46]. Indeed, it is hypothesized that SPNs begin as solid tumors when small, and as they enlarge the tumor growth is not supported by an adequate vascular network, resulting in cystic and hemorrhagic degeneration.…”

“…SPN is a rare and slow-growing pancreatic neoplasm and predominantly occurs in young women (mean age 30 years), who are most often asymptomatic at presentation [44,45]. Mostly, the tumor arises in the pancreatic head and tail and has a tendency to displace structures rather than invading them.…”

“…Another characteristic imaging hallmark of SPNs is the combination of a central area of internal hemorrhage and cystic degeneration, and peripheral rim of solid components (fig. 10) [45,46,47]. Peripheral calcification is present in up to 60% of cases, and central dystrophic calcifications may occur in areas of hemorrhage [40,48].…”

“…Classical imaging features of large SPNs consist of a well-circumscribed heterogeneous lesion with a thick (sometimes discontinuous) pseudocapsule (representing fibrosis and compressed pancreatic tissue), typically depicted as low density and low signal intensity (on both T1- and T2-weighted images) on CT and MRI, respectively [45,46,47]. Another characteristic imaging hallmark of SPNs is the combination of a central area of internal hemorrhage and cystic degeneration, and peripheral rim of solid components (fig.…”