J Korean Radiol Soc.  1995 Oct;33(4):587-593.

Focal Pancreatic Enlargement: Differentiation between Pancreatic Adenocarcinoma and Focal Pancreatitis on CT and ERCP

• Kim EK
• Yoo HS
• Kim KW
• Kim HS
• Lee JT
• Yoon SW
• Yu JS

Abstract

PURPOSE
To differentiate the pancreatic adenocarcinoma from focal pancreatitis on CT and ERCP in cases of focal pancreatic enlargement.
MATERIALS AND METHODS
We analysed CT findings of 66 patients of pancreatic adenocarcinoma(n=45) or focal pancreatitis(n=21) with respect to size, density, calcification, pancreatic or biliary duct dilatation, fat plane 0bliteration around the vessels, direction of retroperitoneal extension, lymphadenopathy, pseudocyst formation and atrophy of pancreas. ERCP available in 48 patients were analysed in respect to morphologic appearance of CBD and pancreatic duct, and distance between the two ducts.
RESULTS
The patients in focal pancreatitis were younger with more common history of alcohol drinking. There was no statistical difference in calcifications of the mass (18% in the adenocarcinoma, 33% in the focal pancreatitis), but a tendency of denser, larger number of calcifications was noted in focal pancreatitis. The finding of fat plane obliteration around the vessels were more common in pancreatic adenocarcinoma, and fascial thickenings were more prominent in focal pancreatitis, although not statistically significant. On ERCP, there were no differential points of CBD, pancreatic duct morphology, but distance between the two ducts at the lesion center was more wider in focal pancreatitis.
CONCLUSION
Differentiating focal pancreatitis from pancreatic adenocarcinoma is difficult. However, we should consider the possibility of focal pancreatitis in cases of patients with young age, having alcoholic history in association with CT findings of large numbers of and dense calcifications, and ERCP findings of prominent separation of two duct at the lesion center.

MeSH Terms

Adenocarcinoma*
Alcohol Drinking
Alcoholics
Atrophy
Cholangiopancreatography, Endoscopic Retrograde*
Dilatation
Humans
Lymphatic Diseases
Pancreas
Pancreatic Ducts
Pancreatitis*