J Korean Soc Magn Reson Med.  2010 Dec;14(2):139-144. 10.13104/jksmrm.2010.14.2.139.

MR Images and 1H MR Spectroscopy of Enteric Duplication Cyst of the Pancreas in an Adult

• Park SH
• Kim MY
• Suh CH
• Lee KY
• Choi SJ
• Cho JY

• KMID: 2206912
• DOI: http://doi.org/10.13104/jksmrm.2010.14.2.139

Abstract

Enteric duplications associated with the pancreas are especially uncommon, and the differential diagnosis of pancreatic duplication cysts is often difficult, and may be confused with various cystic lesions of the pancreas. We report a case of pancreatic duplication cyst; present the images and laboratory findings including cyst fluid tumor markers. MR and MRS findings enabled the detection of the location, contour, characteristics of cystic fluid and definition of tissue planes between the lesion and adjacent structures, providing useful information for an accurate surgical approach.

Keyword

Pancreas; Duplication cyst; Magnetic resonance (MR); Magnetic resonance spectroscopy (MRS); Computed tomography (CT)

MeSH Terms

Adult
Cyst Fluid
Diagnosis, Differential
Humans
Magnetic Resonance Spectroscopy
Pancreas
Biomarkers, Tumor

Figure

• 

  Fig. 1 (a) Ultrasound image shows a spherical (S) and tubular (T) cystic mass, containing relatively echogenic materials in spherical cyst of pancreatic head. (b) Contrast enhanced CT scan demonstrates a spherical and tubular cystic mass arising from the pancreatic head and partially invaded in body, and free distal portion of tubular cystic lesion (*). (c) Axial T1-weighted and (d) T2-weighted MR images reveal a hypointense and hyperintense cystic mass without septation or a mural nodule in the pancreatic head and body. (e) MRCP shows normal pancreatic main duct (arrowheads) without distension and a cystic mass (asterisk). (f) MR spectroscopy shows minimal peak in 1.31 ppm (*) and non-specific peaks. (g) Surgical specimen shows a dumbbell-shaped spherical (S, arrows) and tubular (T, arrowheads) mass partly covered by pancreatic tissue. It is filled with yellowish mucoid materials. Inner surface of the cyst is partly covered by necrotic debris. (h) Microscopic examination of the cystic mass shows mildly inflamed gastric antral and fundic mucosa along with intact submucosa, muscularis mucosa, and proper muscle coats (H&E ×200). (i) The other portion of cystic mass comprised of respiratory mucosa and underlying normal smooth muscle coats (H&E ×200).

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