CT imaging features and their correlation with pathological findings of solid pseudopapillary tumor of pancreas.

Zheng X, Tan X, Wu B.

Abstract

To analyze the CT features of solid pseudopapillary tumor of pancreas （SPTP）, and correlation with the pathological findings of the disease so as to improve the diagnostic abilities, the CT images and the clinical manifestations, we retrospectively analyzed the pathological materials of 23 cases with surgery and pathology proved SPTP. In the 23 patients, 21 cases were female （91.3%） and 2 were male （8.7%）. The most common symptom was abdominal discomfort with dull pain in 12 patients （52.2%）. Others included the pancreatic mass that was detected incidentally during physical examination in 9 patients （39.1%）, nausea/vomiting in 2 patients （8.7%）. And 1 case of female patients had 2 lesions. In the 24 tumors, 6 cases were located at the head （25.0%）, 3 were at neck （12.5%）, 8 cases were at body （33.3%）, and 7 cases were at tail of pancreas respectively （29.2%）. The long-axis diameter ranged from 2.1 cm to 20.1 cm （mean 6.4 cm）. 9 tumors were mostly solid component （37.5%）, 10 tumors were contained similar proportion of solid and cystic part （41.7%）, and mainly cystic components in 5 tumors （20.8%）. In 9 of the 23 patients, calcification was found in the tumor （39.1%）. In 2 of the 23 patients, bleeding was seen in the mass （8.7%）. The dilation of intrahepatic bile duct was found in 1 patient （8.7%）. Liver metastasis was showed in one patient （8.7%）. On post-contrast CT scan, solid parts demonstrated mild enhancement at the arterial phase. At the portal phase, solid parts were enhanced continuously in all cases, and the enhancement degrees were lower than normal pancreatic tissue. The cystic parts of all lesions showed no enhancement. Pseudo papillary structure, hemorrhage, necrosis, or cystic degeneration were found in all patients by histological study. In a word, SPTP has comparatively characteristic CT imaging features consistent with histological features, when combined with clinical manifestations, could be correctly diagnosed and differentially diagnosed.

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2014 Feb;31（1）:107-12.

PMID: 24804494 [PubMed - in process]