Intraductal papillary mucinous neoplasm
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Cystic abnormality identified on ultrasound. MRI performed for delineation.
Patient Data
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Cystic lesion in the tail of pancreas, with a 'bunch of grape' appearance. It is continuous with the main pancreatic duct.
2 case questions available
Q: What types of IPMN exist? show answer
A: There is a main duct and a side-branch type.
Q: Are IPMN lesions exclusively malignant? show answer
A: Lesions can be benign or malignant or benign and become malignant. Some work has been done suggesting duct wall nodules and enhancement of the MPD walls are signs of malignant MPD or mixed type IPMNs on MRI (see reference 2). This diagnostic difficulty if partly why there is no consensus on treatment.
Case Discussion
Multilobulated cyst in the tail of pancreas, contiguous with the main pancreatic duct, with a bunch of grapes appearance, consistent with an intraductal papillary mucinous neoplasm of the pancreas (IPMN).
The pancreatic parenchyma is normal - no evidence of chronic pancreatitis.
References
- 1. Gourgiotis S, Ridolfini MP, Germanos S. Intraductal papillary mucinous neoplasms of the pancreas. Eur J Surg Oncol. 2007;33 (6): 678-84. doi:10.1016/j.ejso.2006.11.031 - Pubmed citation
- 2. Manfredi R, Graziani R, Motton M et-al. Main pancreatic duct intraductal papillary mucinous neoplasms: accuracy of MR imaging in differentiation between benign and malignant tumors compared with histopathologic analysis. Radiology. 2009;253 (1): 106-15. Radiology (full text) - doi:10.1148/radiol.2531080604 - Pubmed citation
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