Web Training Modules Module 14: Advanced Abdominal Imaging, Part I Liver, Pancreas, Spleen

Total Page:16

File Type:pdf, Size:1020Kb

Web Training Modules Module 14: Advanced Abdominal Imaging, Part I Liver, Pancreas, Spleen Web Training Modules Module 14: Advanced Abdominal Imaging, Part I Liver, Pancreas, Spleen Web Training Modules | Module 14: Advanced Abdominal Imaging, Part I Liver ............................................................................................................................................................... 6 Anatomy .................................................................................................................................................... 6 Physiology ................................................................................................................................................. 8 Digestion ............................................................................................................................................... 9 Metabolism ........................................................................................................................................... 9 Detoxification ........................................................................................................................................ 9 Storage ................................................................................................................................................ 10 Production ........................................................................................................................................... 10 Immunity ............................................................................................................................................. 10 MR Imaging of Liver Pathology ............................................................................................................... 10 Non-Contrast Enhanced Liver MRI ...................................................................................................... 11 Contrast-Enhanced Liver MRI ............................................................................................................. 12 Gadolinium Contrast Agents ........................................................................................................... 13 Hepatobiliary Contrast Agents ........................................................................................................ 13 Superparamagnetic Contrast Agents .............................................................................................. 14 Benign Focal Liver Disease .................................................................................................................. 15 Hemangiomas ................................................................................................................................. 15 Focal Nodular Hyperplasia .............................................................................................................. 16 Hepatic Adenomas .......................................................................................................................... 17 Benign Lipomatous Tumors ............................................................................................................ 17 Malignant Hepatic Lesions .................................................................................................................. 18 Hepatocellular Carcinomas ............................................................................................................. 18 Cholangiocarcinomas ...................................................................................................................... 19 Fibrolamellar Hepatocellular Carcinomas ....................................................................................... 19 Metastases ...................................................................................................................................... 20 Lymphoma ...................................................................................................................................... 21 Diffuse Liver Disease ........................................................................................................................... 21 Liver Abscesses................................................................................................................................ 22 Hemochromatosis ........................................................................................................................... 23 Steatohepatitis ................................................................................................................................ 23 Fatty Liver ........................................................................................................................................ 23 2 Web Training Modules | Module 14: Advanced Abdominal Imaging, Part I Cirrhosis .......................................................................................................................................... 24 Passive Venous Congestion ............................................................................................................. 24 Pancreas ...................................................................................................................................................... 25 Anatomy .................................................................................................................................................. 25 Physiology ............................................................................................................................................... 28 Regulation of Blood Glucose Levels .................................................................................................... 28 Glucagon Regulation ........................................................................................................................... 29 Insulin Regulation................................................................................................................................ 29 MR Imaging of Pancreas Pathology ........................................................................................................ 30 Ductal Pancreatic Adenocarcinoma .................................................................................................... 33 Cystic Epithelial Pancreatic Neoplasms .............................................................................................. 34 Serous Cystadenoma....................................................................................................................... 34 Mucinous Cystic Tumors ................................................................................................................. 36 Solid Pseudopapillary Tumors ......................................................................................................... 37 Intrapapillary Mucinous Neoplasm ................................................................................................. 38 Endocrine Pancreatic Tumors ............................................................................................................. 39 Hyperfunctioning Tumors ............................................................................................................... 39 Nonhyperfunctioning Endocrine Tumors ........................................................................................ 40 MR Imaging of Hyperfunctioning and Nonhyperfunctioning Endocrine Tumors ........................... 40 Additional Endocrine Tumors ......................................................................................................... 40 Pancreatitis ......................................................................................................................................... 41 Acute Pancreatitis ........................................................................................................................... 41 Chronic Pancreatitis ........................................................................................................................ 41 Focal Pancreatitis ............................................................................................................................ 42 Spleen.......................................................................................................................................................... 43 Anatomy .................................................................................................................................................. 43 Physiology ............................................................................................................................................... 44 Immune Responses ............................................................................................................................. 44 Phagocytosis ....................................................................................................................................... 45 Hematopoiesis .................................................................................................................................... 45 Storage of Red Blood Cells .................................................................................................................. 45 3 Web Training Modules | Module 14: Advanced Abdominal Imaging, Part I MR Imaging of Spleen Pathology ............................................................................................................ 46 Normal Variants and Congenital Diseases .........................................................................................
Recommended publications
  • Complications of Splenectomy 2020; 4(2): 218-222 Received: 08-02-2020 Dr
    International Journal of Surgery Science 2020; 4(2): 218-222 E-ISSN: 2616-3470 P-ISSN: 2616-3462 © Surgery Science Complications of splenectomy www.surgeryscience.com 2020; 4(2): 218-222 Received: 08-02-2020 Dr. Ketan Vagholkar Accepted: 10-03-2020 Dr. Ketan Vagholkar DOI: https://doi.org/10.33545/surgery.2020.v4.i2d.420 Professor, Department of Surgery. DY Patil University School of Abstract Medicine Navi Mumbai, Spleen is an important organ of the reticuloendothelial system. It plays a crucial role in the immunological Maharashtra, India system of the body. Understanding the consequences and diagnosis of hyposlenic and asplenic states is essential. Splenectomy is performed for a variety of indications ranging from haematological conditions to trauma. Complications of splenectomy include surgical as well as immunological. Overwhelming post splenectomy infection is one of the most dreaded complication with high mortality. The physiological basis of immunological function of the spleen, hyposplenism and complications of splenectomy are presented in this paper. Keywords: Post splenectomy, complications, hyposplenia, OPSI Introduction Spleen is a very important constituent organ of the reticuloendothelial system. The organ is crucial in regulating immune homeostasis through its ability to link innate and adoptive immunity in the process of protecting against infection. Hyposplenism is impairment of splenic function. It is usually acquired and caused by severe haematological and immunological disorders. Asplenia refers to the absence of the spleen which is rarely congenital but predominantly post-surgical (splenectomy). The most important complication of asplenic state is infectious complications [1]. These infections have high mortality. In addition to infectious complications, splenectomy can lead to a series of other complications.
    [Show full text]
  • Well-Differentiated Angiosarcoma of Spleen: a Teaching Case Mimicking
    Xu et al. World Journal of Surgical Oncology (2015) 13:300 DOI 10.1186/s12957-015-0716-1 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access Well-differentiated angiosarcoma of spleen: a teaching case mimicking hemagioma and cytogenetic analysis with array comparative genomic hybridization Lichen Xu1†, Yimin Zhang1†, Hong Zhao1, Qingxiao Chen2, Weihang Ma1,3* and Lanjuan Li1 Abstract Primary splenic angiosarcoma is extremely rare but aggressive malignant vascular neoplasm. Here, we report a case of vascular tumor in spleen that was initially misinterpreted as hemangioma. Two years after splenectomy, the patient admitted again with aggravated abdomen pain and severe anemia. The magnetic resonance imaging (MRI) scan showed widely metastases. The ensuing biopsy for lesion both in liver and in bone marrow showed the similar pathological findings as that in spleen, which supported the final diagnosis of well-differentiated splenic angiosarcoma with extensive metastases. The patient was dead in 3 months after discharge without chemotherapy. The copy number changes for spleen lesion detected by array comparative genome hybridization showed copy number gain at 11q23.2, 11q24.3, 12q24.33, 13q34, copy number loss at 1q24.2-q31.3, 1q41-q42.2, 1 q42.3-q43, 2q36.3-q37.3, 2q37.7, 3q13.33-q26.2, 3q28 - q29, 9p11.2, 13q11, 15q11, homozygous copy loss at 8p11.22, 22q11.23. Less than 200 cases of splenic angiosarcoma have been published in literature of English. To the best of our knowledge, this is the first time analyzed cytogenetic alteration in a well-differentiated primary splenic angiosarcoma. Keywords: Angiosarcoma, Well-differentiation, Splenectomy, Array comparative genomic hybridization, Copy number change Background cytogenetic changes to this subgroup of angiosarcoma Primary splenic angiosarcoma (PSA) is a rare malignant has been published.
    [Show full text]
  • Human Autoimmunity and Associated Diseases
    Human Autoimmunity and Associated Diseases Human Autoimmunity and Associated Diseases Edited by Kenan Demir and Selim Görgün Human Autoimmunity and Associated Diseases Edited by Kenan Demir and Selim Görgün This book first published 2021 Cambridge Scholars Publishing Lady Stephenson Library, Newcastle upon Tyne, NE6 2PA, UK British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Copyright © 2021 by Kenan Demir and Selim Görgün and contributors All rights for this book reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the copyright owner. ISBN (10): 1-5275-6910-1 ISBN (13): 978-1-5275-6910-2 TABLE OF CONTENTS Preface ...................................................................................................... viii Chapter One ................................................................................................. 1 Introduction to the Immune System Kemal Bilgin Chapter Two .............................................................................................. 10 Immune System Embryology Rümeysa Göç Chapter Three ............................................................................................. 18 Immune System Histology Filiz Yılmaz Chapter Four .............................................................................................. 36 Tolerance Mechanisms and Autoimmunity
    [Show full text]
  • Accessory Spleen ORIGINAL RESEARCH ARTICLE
    IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 10 Ver.III (Oct. 2015), PP 01-03 www.iosrjournals.org Accessory spleen ORIGINAL RESEARCH ARTICLE V. Durgesh*1, CH. Roja Rani2 1Associate Professor Department of Anatomy Faculty of Medicine Maharajah Institute of Medical Sciences Nellimarla Vizianagaram district Andhra Pradesh 2.Assistant Professor Mims, Nellimarla Vizianagaram Distrct Andhrapradesh Abstract: Accessory spleen is a congenital failure of fusion of splenicules usually found close to the splenic hilum or in the greater omentum or tail of the pancreas. Though mostly asymptomatic, these could confuse the diagnosis of certain tumors and also be the cause of relapse post splenectomy. The aim of this article is to present a case of accessory spleen found during the dissection and discuss the various diagnostic procedures, clinical implications and focus on splenosis. Key words: accessory spleen, splenosis, dorsal mesogastrium I. Introduction During the fifth week of intrauterine life, mesenchymal condensations called ‘splenicules” start to appear in the left leaf of dorsal mesogastrium which eventually fuse to form the spleen. Any failure of this fusion results in small splenic tissues developing separately and resulting in accessory spleens. They are relatively common, with an autopsy study involving 3000 patients identifying 364 accessory spleens, of which 61 were found in the pancreatic tail. The pancreatic tail and the splenic hilum are the most common sites though accessory spleens can be found anywhere along the line of dorsal mesogastrium and close to the urogenital ridge such as the stomach, jejunum, mesentery as well as the ovaries, spermatic cord,scrotum1and testis.
    [Show full text]
  • Post-Splenectomy Sepsis: a Review of the Literature
    Open Access Review Article DOI: 10.7759/cureus.6898 Post-splenectomy Sepsis: A Review of the Literature Faryal Tahir 1 , Jawad Ahmed 1 , Farheen Malik 2 1. Internal Medicine, Dow University of Health Sciences, Karachi, PAK 2. Pediatrics, Dow University of Health Sciences, Karachi, PAK Corresponding author: Jawad Ahmed, [email protected] Abstract The spleen is an intraperitoneal organ that performs vital hematological and immunological functions. It maintains both innate and adaptive immunity and protects the body from microbial infections. The removal of the spleen as a treatment method was initiated from the early 1500s for traumatic injuries, even before the physiology of spleen was properly understood. Splenectomy has therapeutic effects in many conditions such as sickle cell anemia, thalassemia, idiopathic thrombocytopenic purpura (ITP), Hodgkin’s disease, and lymphoma. However, it increases the risk of infections and, in some cases, can lead to a case of severe sepsis known as overwhelming post-splenectomy infection (OPSI), which has a very high mortality rate. Encapsulated bacteria form a major proportion of the invading organisms, of which the most common is Streptococcus pneumoniae. OPSI is a medical emergency that requires prompt diagnosis (with blood cultures and sensitivity, blood glucose levels, renal function tests, and electrolyte levels) and management with fluid resuscitation along with immediate administration of empirical antimicrobials. OPSI can be prevented by educating patients, vaccination, and antibiotic prophylaxis.
    [Show full text]
  • (ACR), Case in Point
    Selected Publications Duran A, Heller G. Tuberculum Sellae Meningioma. American College of Radiology (ACR), Case in ​ ​ Point. July 2020. ​ ​ Gromis J, Moore JA, Van Kouwenberg, Benitez CL. Wrist Extensor Tendon “Floating Fat” Sign: A ​ ​ ​ Strong Indicator to Recognize Occult Fractures in the Distal Radius. Journal of Bone and Joint ​ Surgery Case Connector. Accepted 2020 June, awaiting PMID. ​ ​ ​ Grover H, Grover SB, Goyal P, Hedge R, Gupta S, Malhotra S, Li S, Gupta N. Clinical and imaging ​ features of idiopathic granulomatous mastitis - The diagnostic challenges and a brief review. Clinical Imaging. Accepted 2020 June, awaiting PMID. ​ ​ ​ Doo FX, Kassim G, Lefton D, Patterson S, Pham H, Belani P. Unusual neurological presentations of ​ ​ ​ COVID-19: Leukoencephalopathy and carotid Thrombosis. Clinical Imaging. Accepted June 7 2020, ​ ​ awaiting PMID. ​ Zaman O, Doo FX, Shah S, Pfaff HC, Kamath A, Gastropulmonary fistula. American College of ​ ​ Radiology (ACR), Case in Point. 2020. ​ Chundru K, Roudenko A, Pham H, Benitez CL. Analysis of Different Levels of Structured Reporting ​ ​ ​ in Knee Magnetic Resonance Imaging. Academic Radiology. 2020 February. PMID: 32037259 ​ ​ Doo FX, Khorsandi A, Avanessian B, Bowers M, Somwaru A . Gender Affirmation Surgery: A Primer ​ on Imaging Correlates for the Radiologist. American Journal of Roentgenology. 2019 December. ​ ​ PMID: 31414889. Nguyen B, Doo FX, Hannan P, Hayon R. Chapter 5 - Prevention. The Equal Curriculum: Student and ​ ​ ​ Educator Guide to LGBT Health (1st ed. Springer Press). 2019 October. ISBN 978-3-030-24025-7 ​ (ebook), ISBN 978-3-030-24024-0 (softcover). Gunio D, Vulcano E, Benitez C. Dynamic Stress MR-imaging of Midfoot Injuries: Measurable ​ Morphology and Laxity of the Sprained Lisfranc Ligament during Mechanical Loading: A Case Report.
    [Show full text]
  • Accessory Spleen Mimicking Pancreatic Tumour: Evaluation by 99Mtc-Labelled Colloid SPECT/CT Study
    Folia Morphol. Vol. 74, No. 4, pp. 532–539 DOI: 10.5603/FM.2015.0119 C A S E R E P O R T Copyright © 2015 Via Medica ISSN 0015–5659 www.fm.viamedica.pl Accessory spleen mimicking pancreatic tumour: evaluation by 99mTc-labelled colloid SPECT/CT study. Report of two cases and a review of nuclear medicine methods utility M. Pachowicz1, 2, A. Mocarska3, E. Starosławska3, Ł. Pietrzyk2, 4, B. Chrapko1 1Chair and Department of Nuclear Medicine, Medical University of Lublin, Poland 2Department of Didactics and Medical Simulation, Medical University of Lublin, Poland 3St. John’s Cancer Centre, Lublin, Poland 4General and Minimally Invasive Surgery Department, 1st Clinical Military Hospital, Lublin, Poland [Received 31 August 2014; Accepted 13 January 2015] The accessory spleen is a common congenital anomaly, typically asymptomatic and harmless to the patient. However, in some clinical cases, this anomaly beco- mes significant as it can be mistaken for a tumour or lymph node and be missed during a therapeutic splenectomy. There are nuclear medicine modalities which can be applied in the identification and localisation of an accessory spleen. They include scintigraphy with radiolabelled colloids or heat damaged red blood cells, which are trapped in the splenic tissue. Modern techniques, including hybrid imaging, enable simultaneous structure and tracer distribution evaluations. Additionally, radiation-guided surgery can be used in cases where the accessory spleen, which is usually small (not exceeding 1 cm) and difficult to find among other tissues, has to be removed. In the study, we would like to present 2 cases of patients in which the malignancy had to be excluded for the reason that the multiple accessory spleens were very closely related to the pancreas.
    [Show full text]
  • Accessory Spleen: a Clinically Relevant Anatomic Anomaly
    Jemds.com Original Article ACCESSORY SPLEEN: A CLINICALLY RELEVANT ANATOMIC ANOMALY Prachi Saffar Aneja1, Amit Kumar Saxena2, Ankur Sharma3 1Associate Professor, Department of Anatomy, Faculty of Medicine and Health Sciences, SGT University, Gurgaon. 2Associate Professor, Department of Anatomy, Faculty of Medicine and Health Sciences, SGT University, Gurgaon. 3Tutor, Department of Anatomy, Faculty of Medicine and Health Sciences, SGT University, Gurgaon. ABSTRACT The purpose of our study is to emphasize on the clinical relevance of the presence of accessory spleen. It is not only a well- documented anatomic anomaly, it holds special significance in the differential diagnosis of intra-abdominal tumours and lymphadenopathy. MATERIALS AND METHODS Thirty male cadavers from North Indian population above the age of 60 yrs. were dissected in the Anatomy Department of FMHS, SGT University, Gurgaon, over a period of 5 yrs. (Sep 2010-Aug 2015) and presence of accessory spleen recorded. Tissue from the accessory spleen was also subjected to routine histological processing and slide prepared by haematoxylin and eosin staining. RESULTS Accessory spleen was present in two cadavers near the splenic hilum. One was 3.9 cm in the long axis and weighed about 48.4 grams, while the other was 1.2 cm in long axis and weighed about 12.5 grams. One had a separate arterial branch from the main splenic artery; that it was splenic tissue was confirmed histologically. DISCUSSION The presence of accessory spleen is considered to be due to embryonic non-fusion of the splenic aggregate with the main mass. CONCLUSION Though accessory spleen in itself pose no clinical problems, its significance cannot be undermined.
    [Show full text]
  • Incomplete Penetrance for Isolated Congenital Asplenia in Humans with Mutations in Translated and Untranslated RPSA Exons
    Incomplete penetrance for isolated congenital asplenia in humans with mutations in translated and untranslated RPSA exons Alexandre Bolzea,b, Bertrand Boissona,c,d,1, Barbara Boscha, Alexander Antipenkoa, Matthieu Bouazizc,d, Paul Sacksteina, Malik Chaker-Margote, Vincent Barlogisf, Tracy Briggsg,h, Elena Colinoi, Aurora C. Elmorej, Alain Fischerd,k,l,m,n, Ferah Genelo, Angela Hewlettp,MaherJedidiq, Jadranka Kelecicr,RenateKrügers, Cheng-Lung Kut, Dinakantha Kumararatneu, Alain Lefevre-Utilev, Sam Loughlinw, Nizar Mahlaouid,k,l,n, Susanne Markusx, Juan-Miguel Garciay, Mathilde Nizonz, Matias Oleastroaa,MalgorzataPacbb, Capucine Picardd,k,cc, Andrew J. Pollarddd, Carlos Rodriguez-Gallegoee, Caroline Thomasff,HorstVonBernuths,gg,hh, Austen Worthii, Isabelle Meytsjj,kk, Maurizio Risolinoll,mm,nn,oo,pp, Licia Sellerill,mm,nn,oo,pp, Anne Puela,c,d, Sebastian Klingee,LaurentAbela,c,d, and Jean-Laurent Casanovaa,c,d,l,qq,1 aSt. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY 10065; bHelix, San Carlos, CA 94070; cLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, 75015 Paris, France; dImagine Institute, Paris Descartes University, 75015 Paris, France; eLaboratory of Protein and Nucleic Acid Chemistry, The Rockefeller University, New York, NY 10065; fPediatric Hematology, University Hospital of Marseille, 13005 Marseille, France; gManchester Centre for Genomic Medicine, Saint Mary’s Hospital, Manchester University Hospitals NHS Foundation Trust
    [Show full text]
  • Hawaii Birth Defects Surveillance Report 1986-2005
    Hawai‘i State Department of Health Hawai‘i Birth Defects Program Hawai‘i Birth Defects Surveillance Report 1986-2005 Aloha! Birth defects can have a significant impact on children and their families. Major structural and genetic birth defects may result in serious illness, developmental delays, long term disability, and/or death. As a result, more health care, education, and social services may be needed throughout childhood and adolescence and into adult life. The Hawai„i State Department of Health is pleased to present 20 years of data in this Hawai„i Birth Defects Surveillance Report for 1986-2005. The report highlights trends in birth defects and variation by county of residence, maternal ethnicity, prenatal care, and other factors. It is hoped that birth defects data may be useful for developing public health policy and community strategies to prevent birth defects. Data may also be used in planning services to ensure that children with birth defects have the necessary services for optimal health, growth, and development. Attention to a vulnerable population of children with special health care needs contributes toward improving the health of all children in Hawai„i. Loretta J. Fuddy, A.C.S.W., M.P.H. Director of Health Promoting Lifelong Health & Wellness November 2011 BIRTH DEFECTS DATA IN HAWAI‘I, 1986-2005 Summary Annual rate 4.4% of births have a major structural and/or genetic birth defect. The most common birth defect categories are cardiac & circulatory, limb & musculoskeletal, and genital & urinary conditions. Of birth defect cases, 30% involve two or more categories of birth defects. Trends Birth defect trends from 1986 to 2005 were varied, with 12 birth defect conditions having significant increasing trends, 44 having no change, and 41 having significant decreasing trends.
    [Show full text]
  • Benign Diseases of the Spleen 7 8 Refaat B
    111 2 3 10 4 5 6 Benign Diseases of the Spleen 7 8 Refaat B. Kamel 9 1011 1 2 3 4 5 6 7 8 9 2011 1 Aims ● Splenic conservation, various tech- 2 niques. 3 ● Identifying the value and functions of the ● Splenic injuries and management. 4 spleen in health and diseases. 5 ● The role of spleen in haematological dis- 6 orders (sickle cell disease, thalassaemia, Introduction 7 spherocytosis, idiopathic thrombocy- 8 topenic purpura). The spleen has always been considered a mys- 9 terious and enigmatic organ. Aristotle con- ● Haematological functions of the spleen 3011 cluded that the spleen was not essential for life. (haemopoiesis in myeloproliferative 1 As a result of this, splenectomy was undertaken disorders, red blood cell maturation, 2 lightly, without a clear understanding of subse- removal of red cell inclusions and 3 quent effects. Although Hippocrates described destruction of senescent or abnormal red 4 the anatomy of the spleen remarkably accu- cells) and immunological functions 5 rately, the exact physiology of the spleen con- (antibody production, removal of partic- 6 tinued to baffle people for more than a 1000 ulate antigens as well as clearance of 7 years after Hippocrates. The spleen was thought immune complex and phagocytosis 8 in ancient times to be the seat of emotions but (source of suppressor T cells, source 9 its real function in immunity and to remove of opsonin that promotes neutrophil 4011 time-expired blood cells and circulating phagocytosis and production of 1 microbes, has only recently been recognised. “tuftsin”). 2 3 ● Effects of splenectomy on haematologi- 4 cal and immunological functions.
    [Show full text]
  • Rare Tumors and Lesions of the Pancreas
    Rare Tumors and Lesions of the Pancreas John A. Stauffer, MD, Horacio J. Asbun, MD* KEYWORDS Pancreatectomy Pancreatic neoplasm Anaplastic carcinoma Adenosquamous carcinoma Solid pseudopapillary tumor Acinar cell carcinoma Primary pancreatic lymphoma Unusual pancreas tumors KEY POINTS Rare pancreatic tumors of the pancreas include adenocarcinoma variants, such as anaplastic carcinoma, adenosquamous carcinoma, colloid, hepatoid, and medullary carcinoma. Other neoplasms include acinar cell carcinoma, solid pseudopapillary tumor, sarcomas, or lymphomas. Benign solid or cystic masses, such as hamartoma, hemangioma, lymphangioma, or others also may mimic neoplastic disease. The pancreas may be the site of isolated metastatic disease, such as renal cell cancer, colorectal cancer, melanoma, and other carcinomas. Pancreatic inflammatory diseases may mimic solid neoplasms of the pancreas. Primary pancreatic ductal adenocarcinoma (PDAC) is the most common neoplasm of the pancreas. Pancreatic neuroendocrine tumors (PNETs) are much less common but their incidence has increased over the past decade due to the increased use of cross- sectional imaging.1 Cystic lesions, such as intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasms (MCN), and serous cystic neoplasms (SCN) are also relatively common. The pancreas is a complex organ that harbors a wide array of diseases. There are a variety of non-neoplastic conditions that mimic PDAC, such as groove pancreatitis (GP) and autoimmune pancreatitis (AIP).2,3 Additionally, there are a handful of other rare neoplastic lesions infrequently found in patients with pancreatic masses that range from well known (eg, solid pseudopapillary neoplasm and acinar cell carcinoma) to less well known (eg, leiomyosarcoma and hepatoid carcinoma). Rare cystic lesions can be misdiagnosed for the more common Disclosures: The authors have nothing to disclose.
    [Show full text]