Solid and Papillary Epithelial Neoplasm of the Pancreas: Radiologic-Pathologic Correlation

Kim, Ji Hyung; Kim, Ki Whang; Cho, Nam Hoon

Abstract

PURPOSE
To report variable radiologic manifestastions and to accomplish detailed radiologic-pathologic correlation of solid and papillary epithelial neoplasm of the pancreas.
MATERIALS AND METHODS
In 23 patients with surgically confirmed solid and papillary epithelial neoplasm, retrospective examinations of operative records, gross and micropathologic findings, and radiologic findings including US(n=17), CT(n=23), ERCP(n=9), MRI(n=3) were carried out. On the basis of pathologic findings, detailed analysis of radiologic findings of solid and papillary epithelial neoplasm was then performed.
RESULTS
Most pancreatic solid and papillary epithelialneoplasms(n=17) were seen as a mass with heterogeneous internal density consisting of cystic change, hemorrhagicnecrosis, and tumor tissue, although the mass can also be seen to be homogeneous(n=6). On gross specimens, acapsule which showed enhancement on the delayed phase of the enhanced CT scan was demonstrated in 22 cases. It was seen as an echogenic rim on the ultrasound images and as a low signal rim on the MR images. Calcification of themass was seen in ten cases, nine of which showed peripheral calcification along the tumor capsule ; five cases showed calcifications within the mass. On pathologic examination, ten cases had a single or multiple cystic appearance ; in seven of these cases, this appeared on CT scan.
CONCLUSIONS
In addition to usual mixed internal density caused by hemorrhagic necrosis of the tumor, enhanced capsule and internal multicystic appearance on CT scan were other characteristics of pancreatic solid and papillary epithelial neoplasm. These could be useful findings in the radiologic approach and in the differential diagnosis of pancreatic masses.