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Pancreatic ductal adenocarcinoma with intratumoral cystic lesions on MRI: correlation with histopathological findings
British Journal of Radiology, 07/28/09

Yoon SE et al. - In a trial to evaluate intratumoral cystic lesions of pancreatic ductal adenocarcinoma (PDAC) depicted on MRI, and to correlate these cystic lesions with their histopathological findings, it was reported that the intratumoral cystic lesions of PDACs on MRI were classified as either neoplastic mucin cysts with smooth margins and eccentric locations or cystic necroses with irregular margins and centric locations.

Methods

This study included 12 pts (7 males and 5 females; mean age, 59 yrs) with intratumoral cystic lesions of PDAC detected on a retrospective MRI review.
Histopathological findings of the cystic lesions within PDACs were reviewed and MRI findings were analyzed, focusing on appearance of the intratumoral cystic lesions, ie, the size, number, margin, and intratumoral location, and on the ancillary findings of PDAC, i.e. peripancreatic infiltration, upstream pancreatic duct dilatation, and distal parenchymal atrophy.

Results

Intratumoral cystic lesions were classified as neoplastic mucin cysts (n=7, 58%) or cystic necrosis (n=5, 42%) according to histopathological findings; they ranged in greatest dimension from 0.5 cm to 3.4 cm.
7 pts had only 1 cystic lesion each, while 5 had multiple cystic lesions.
Most of the neoplastic mucin cysts had smooth margins (n=6, 86%) and eccentric locations (n=6), whereas most cystic necroses had irregular margins (n=4, 80%) and centric locations (n=4).
Most common ancillary findings of PDAC were peripancreatic infiltration, distal pancreatic atrophy, and upstream pancreatic duct dilatation (92%, 75% and 58%, respectively).

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