PICTORIAL ESSAY   

Il Giornale Italiano di Radiologia Medica 2019 Luglio-Agosto;6(4):342-55

DOI: 10.23736/S2283-8376.19.00205-5

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

Cystic pancreatic neoplasms: a differential diagnosis on CT and MR imaging

Silvia PELLEGRINO, Dario GIAMBELLUCA ✉, Roberto CANNELLA, Cecilia GOZZO, Giovanni CARUANA, Francesco ALLEGRA, Giuseppe CUTAIA, Massimo MIDIRI, Giuseppe SALVAGGIO

Section of Radiological Sciences, Bi.N.D., University of Palermo, Palermo, Italy

Cystic pancreatic lesions encompass a varied group of pancreatic abnormalities, including inflammatory, benign, precancerous and frankly malignant entities. Considering the relative frequency of all these lesions, in addition to pseudocysts five neoplasms are by far the most common, accounting for approximately 90% of all pancreatic cystic tumors. Indeed, the current guidelines focus on this group of neoplastic cystic lesions, which consist of intraductal papillary mucinous neoplasm, mucinous cystic neoplasm, serous cystic neoplasm, solid pseudo-papillary neoplasm and cystic neuroendocrine neoplasm. These lesions not only have diverse histological and imaging appearances, but also differ in clinical presentation, biological behavior, growth pattern, and patient-related features. CT and MR imaging are excellent modalities for detection and characterization of cystic pancreatic lesions. CT is the diagnostic modality of choice for the initial detection and evaluation of pancreatic lesions. It can provide excellent visualization of septa, mural nodules and calcifications. CT has also an important role in the assessment of pancreatic parenchyma. MRI facilitates confident assessment of the morphological features of the cysts, as well as their relationship with the pancreatic duct. Moreover, MRI reliably displays small cystic lesions, which are not well depicted on CT images. Radiology is essential to help clinicians into the appropriate management of patients with cystic lesions of the pancreas.

KEY WORDS: Pancreatic neoplasms; Pancreas; Cysts; Tomography, X-Ray Computed; Magnetic resonance imaging