Uncommon pancreatic tumors and pseudotumors

Lalwani, Neeraj; Mannelli, Lorenzo; Ganeshan, Dhakshina Moorthy; Shanbhogue, Krishna; Dighe, Manjiri; Tiwari, Hina Arif; Maximin, Suresh; Monti, Serena; Ragucci, Monica; Prasad, Srinivasa R.

doi:10.1007/s00261-014-0189-7

Cited by 26 publications

(22 citation statements)

References 43 publications

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“…In contrast, pancreatic adenocarcinoma will commonly dilate the more distal pancreatic duct when more proximal ductal invasion has occurred [3]. Another helpful clue is if bulky lymphadenopathy is seen below the level of the renal veins, lymphoma is more likely the culprit rather than adenocarcinoma [3,4]. With MRI, pancreatic lymphoma generally demonstrates low signal characteristics within the pancreas on T1-weighted images with subtle enhancement following gadolinium-containing contrast.…”

Section: Discussionmentioning

confidence: 99%

Knife wielding radiologist: A case report of primary pancreatic lymphoma

Cagle

Holbert

Wolanin

et al. 2018

European Journal of Radiology Open

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Majority of malignant pancreatic neoplasms are epithelial in origin and mostly arise from exocrine gland. Ductal adenocarcinoma compromises the major histological type of such tumors. Primary non-epithelial tumors of exocrine pancreatic gland are extremely rare and incorporate lymphoma and sarcoma. Primary pancreatic lymphoma compromises less than 0.5% of pancreatic malignancies. Primary pancreatic lymphoma can be difficult to differentiate from pancreatic adenocarcinoma and other neoplasms on imaging, and a correct diagnosis is crucial for appropriate patient management.

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Section: Discussionmentioning

confidence: 99%

Knife wielding radiologist: A case report of primary pancreatic lymphoma

Cagle

Holbert

Wolanin

et al. 2018

European Journal of Radiology Open

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“…The diffuse form (the most frequent, 70% of cases); the pancreas has a characteristic sausage-like appearance with diffuse enlargement and loss of the lobular contours. It is diffusely hypointense on T1-weighted images and hyperintense on T2-weighted images with diffusely enhancement on delayed phase of dynamic CT and MRI that is characteristic of AIP [4] [6] [9]. A non-enhancing fibrotic rim encircling the affected parenchyma (hypointense on both T1-and T2-weighted images) may also be present [9].…”

Section: Discussionmentioning

confidence: 99%

“…It is diffusely hypointense on T1-weighted images and hyperintense on T2-weighted images with diffusely enhancement on delayed phase of dynamic CT and MRI that is characteristic of AIP [4] [6] [9]. A non-enhancing fibrotic rim encircling the affected parenchyma (hypointense on both T1-and T2-weighted images) may also be present [9]. This form is rarely seen in PC [4].…”

Section: Discussionmentioning

confidence: 99%

“…) irregularity and stricturing of the intra-and extra-hepatic bile ducts. Moreover, no or minimal upstream dilatation, and the absence of metastatic disease can also be helpful to differentiate AIP from PC [6][9].In some cases, when diagnosis is difficult histopathological examination is necessary. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is useful to either diagnose or rule out PC.…”

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confidence: 99%

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IgG4-Unrelated Type 1 Auto Immune Pancreatitis Manifesting with Pancreatic Head Mass Mimicking Cancer

Arrami¹,

Billah²,

Addioui³

et al. 2018

OJCD

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Auto immune pancreatitis (AIP) is an uncommon form of chronic pancreatitis that has been divided into type 1 and type 2 which have distinct histopathology and clinical features. Type 1 AIP seems to be the pancreatic manifestation of an IgG4-related systemic disease, characterized by elevated IgG4 serum levels, infiltration of IgG4-positive plasma cells and extrapancreatic lesions. When manifesting as a focal disease in the pancreas, it can be challenging to differentiate it from pancreatic cancer (PC). Because AIP is typically responsive to steroid therapy without the need for resection, differentiation between these two diseases is critical. We report the case of a 56-year-old man with initial suspect of PC, and final diagnosis of type 1 AIP according to the International Consensus Diagnostic Criteria (ICDC) without elevated levels of serum IgG4 or need for a histology sample. We take a review of literature in order to improve the diagnostic accuracy of AIP and describe clinical and imaging features to differentiate it from PC and avoid unnecessary surgery due to misdiagnosis.

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“…[ 11 ] The imaging role is to localize disease, once clinically suspected. [ 16 , 17 ] Ultrasonography is not specific nor sensitive and has a low negative predictive value. [ 18 ] The most frequent anatomical site is distal part of the pancreas (90% body and tail) making the US identification even more difficult.…”

Section: Discussionmentioning

confidence: 99%

Malignant transformation of glucagonoma with SPECT/CT In-111 OctreoScan features

et al. 2017

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Rationale:Glucagonoma is an uncommon disease but it has been associated with a pattern of symptoms defined as glucagonoma syndrome. These symptoms, if promptly recognized, could help to speed up the diagnosing process.Patient concerns:We report a case of a 68-year-old woman with a pancreatic glucagonoma. Her symptoms at the onset were typical of the glucagonoma syndrome.Diagnoses:After a significant weight loss, she underwent a computer tomography scan of the abdomen, which showed a hypervascular lesion of the tail of the pancreas and hypervascular lesions of the liver. An ultrasound guided biopsy was performed and pathology was consistent with glucagonoma. Her blood glucagon levels were elevated.Outcomes:She was treated with chemotherapy and somatostatin analogs. After 4 years, the disease had a malignant transformation, and metastases suddenly started to grow up. She stopped being responsive to treatment and eventually passed away.Lessons:Due to its rarity, clinical diagnosis is challenging and generally it comes after a long interval since the onset of symptoms. Awareness of physicians and dermatologists of the characteristic necrolytic migratory erythema, and of the other symptoms, often leads to early diagnosis.

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Uncommon pancreatic tumors and pseudotumors

Cited by 26 publications

References 43 publications

Knife wielding radiologist: A case report of primary pancreatic lymphoma

Knife wielding radiologist: A case report of primary pancreatic lymphoma

IgG4-Unrelated Type 1 Auto Immune Pancreatitis Manifesting with Pancreatic Head Mass Mimicking Cancer

Malignant transformation of glucagonoma with SPECT/CT In-111 OctreoScan features

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