Cystic lesions of the pancreas (differential)
Citation, DOI & article data
- Cystic pancreatic mass
- Cystic pancreatic masses
- Pancreatic cysts
- Cystic pancreatic lesions
- Pancreatic cystic lesions
The differential for cystic lesions of the pancreas includes:
-
unilocular
serous cystadenoma uncommonly uni/macrolocular
-
diffuse pancreatic cysts
-
pancreatic cysts occur in association with
-
-
macrocystic: multilocular
mucinous cystic neoplasm of the pancreas: usually body and tail
serous cystadenoma uncommonly uni/macrolocular
hydatid cyst 12
-
microcystic
serous cystadenoma: usually head; 30% have a central scar
-
cystic with a solid component
macrocystic tumors can also have a solid component
primary ductal pancreatic tumor with cystic degeneration
-
cystic degeneration of islet cell tumors (neuroendocrine tumors)
cystic teratoma
Retroperitoneal lesions (extrinsic to the pancreas) can mimic pancreatic cystic lesions, when close to the gland. Examples include:
cystic lymphadenopathy (e.g. necrotic)
Practical points
the American College of Radiology (ACR) published guidelines on managing incidental cystic pancreatic lesions in 2017 11
recent (c.2022) evidence reports that the incidence of pancreatic cancer in asymptomatic patients with cysts <2 cm is similar to background rates 14
References
- 1. Macari M & Megibow A. Focal Cystic Pancreatic Lesions: Variability in Radiologists' Recommendations for Follow-Up Imaging. Radiology. 2011;259(1):20-3. doi:10.1148/radiol.11102437 - Pubmed
- 2. Kawamoto S, Horton K, Lawler L, Hruban R, Fishman E. Intraductal Papillary Mucinous Neoplasm of the Pancreas: Can Benign Lesions Be Differentiated from Malignant Lesions with Multidetector CT? Radiographics. 2005;25(6):1451-68; discussion 1468. doi:10.1148/rg.256055036 - Pubmed
- 2. Sahani D, Kadavigere R, Saokar A, Fernandez-del Castillo C, Brugge W, Hahn P. Cystic Pancreatic Lesions: A Simple Imaging-Based Classification System for Guiding Management. Radiographics. 2005;25(6):1471-84. doi:10.1148/rg.256045161 - Pubmed
- 4. Kalb B, Sarmiento J, Kooby D, Adsay N, Martin D. MR Imaging of Cystic Lesions of the Pancreas. Radiographics. 2009;29(6):1749-65. doi:10.1148/rg.296095506 - Pubmed
- 5. Vyas S, Markar S, Ezzat T, Ajit A. Cystic Lesions of the Pancreas: Current Trends in Approach and Management. Postgrad Med J. 2011;87(1025):207-14. doi:10.1136/pgmj.2010.097279 - Pubmed
- 6. Mathieu D, Guigui B, Valette P et al. Pancreatic Cystic Neoplasms. Radiol Clin North Am. 1989;27(1):163-76. - Pubmed
- 7. Kalb B, Sarmiento J, Kooby D, Adsay N, Martin D. MR Imaging of Cystic Lesions of the Pancreas. Radiographics. 2009;29(6):1749-65. doi:10.1148/rg.296095506 - Pubmed
- 8. Karoumpalis I & Christodoulou D. Cystic Lesions of the Pancreas. Ann Gastroenterol. 2016;29(2):155-61. doi:10.20524/aog.2016.0007 - Pubmed
- 9. Demos T, Posniak H, Harmath C, Olson M, Aranha G. Cystic Lesions of the Pancreas. AJR Am J Roentgenol. 2002;179(6):1375-88. doi:10.2214/ajr.179.6.1791375 - Pubmed
- 10. Khan A, Khosa F, Eisenberg R. Cystic Lesions of the Pancreas. AJR Am J Roentgenol. 2011;196(6):W668-77. doi:10.2214/AJR.10.4378 - Pubmed
- 11. Megibow A, Baker M, Morgan D et al. Management of Incidental Pancreatic Cysts: A White Paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 2017;14(7):911-23. doi:10.1016/j.jacr.2017.03.010 - Pubmed
- 12. Sorogy M, El-Hemaly M, Aboelenen A. Pancreatic Body Hydatid Cyst: A Case Report. Int J Surg Case Rep. 2015;6C:68-70. doi:10.1016/j.ijscr.2014.11.062 - Pubmed
- 13. D'Ippolito G. Incidental Pancreatic Cyst: Still a Lot of Road to Cover. Radiol Bras. 2018;51(4):V-VII. doi:10.1590/0100-3984.2018.51.4e1 - Pubmed
- 14. Nakhaei M, Bligh M, Chernyak V, Bezuidenhout A, Brook A, Brook O. Incidence of Pancreatic Cancer During Long-Term Follow-Up in Patients with Incidental Pancreatic Cysts Smaller Than 2 cm. Eur Radiol. 2022. doi:10.1007/s00330-021-08428-1 - Pubmed
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