TY - JOUR
T1 - Invasive intraductal papillary mucinous neoplasms
T2 - CT features of colloid carcinoma versus tubular adenocarcinoma of the pancreas
AU - Fouladi, Daniel Fadaei
AU - Raman, Siva P.
AU - Hruban, Ralph H.
AU - Fishman, Elliot K.
AU - Kawamoto, Satomi
N1 - Publisher Copyright:
© American Roentgen Ray Society
PY - 2020/5
Y1 - 2020/5
N2 - OBJECTIVE. The purpose of this study is to compare the CT features of colloid carcinoma and tubular adenocarcinoma of the pancreas arising in association with intraductal papillary mucinous neoplasms (IPMNs). MATERIALS AND METHODS. The preoperative CT images of 85 patients with histopathologically proven IPMNs and associated invasive adenocarcinoma located next to each other were retrospectively reviewed. Twenty-nine patients (34.1%; 19 men and 10 women; mean [± SD] age, 68.0 ± 9.5 years) had invasive colloid carcinoma, and 56 patients (65.9%; 31 men and 25 women; mean age, 70.8 ± 10.6 years) had invasive tubular adenocarcinoma. We compared the following CT features between the two groups: IPMN type, main pancreatic duct (MPD) and common bile duct diameters, diameter and characteristics of the largest cystic lesion for branch duct and mixed-type IPMNs, presence of an extracystic or extraductal solid mass next to the cystic lesion or MPD, morphologic features of the upstream MPD in relation to the cystic lesion or solid mass, and presence of a fistula to the adjacent organs. RESULTS. An MPD size of 9.5 mm or greater, a largest cystic lesion diameter of 28 mm or greater, location in the head or neck, septation, calcification, presence of a mural nodule(s) within a cystic lesion or MPD, and presence of a fistula were all more commonly associated with colloid carcinoma. In contrast, presence of an extracystic or extraductal solid mass and an abrupt change in the caliber of the dilated MPD were associated with tubular adenocarcinoma. The best CT feature for differentiating between the two groups was the morphologic features of the upstream MPD in relation to the cystic lesion or solid mass (sensitivity, 81.3%; specificity, 92.3%). CONCLUSION. Preoperative CT is helpful in differentiating two types of invasive carcinoma arising in association with IPMNs. These findings are clinically important because prognosis is better for colloid carcinoma than for tubular adenocarcinoma.
AB - OBJECTIVE. The purpose of this study is to compare the CT features of colloid carcinoma and tubular adenocarcinoma of the pancreas arising in association with intraductal papillary mucinous neoplasms (IPMNs). MATERIALS AND METHODS. The preoperative CT images of 85 patients with histopathologically proven IPMNs and associated invasive adenocarcinoma located next to each other were retrospectively reviewed. Twenty-nine patients (34.1%; 19 men and 10 women; mean [± SD] age, 68.0 ± 9.5 years) had invasive colloid carcinoma, and 56 patients (65.9%; 31 men and 25 women; mean age, 70.8 ± 10.6 years) had invasive tubular adenocarcinoma. We compared the following CT features between the two groups: IPMN type, main pancreatic duct (MPD) and common bile duct diameters, diameter and characteristics of the largest cystic lesion for branch duct and mixed-type IPMNs, presence of an extracystic or extraductal solid mass next to the cystic lesion or MPD, morphologic features of the upstream MPD in relation to the cystic lesion or solid mass, and presence of a fistula to the adjacent organs. RESULTS. An MPD size of 9.5 mm or greater, a largest cystic lesion diameter of 28 mm or greater, location in the head or neck, septation, calcification, presence of a mural nodule(s) within a cystic lesion or MPD, and presence of a fistula were all more commonly associated with colloid carcinoma. In contrast, presence of an extracystic or extraductal solid mass and an abrupt change in the caliber of the dilated MPD were associated with tubular adenocarcinoma. The best CT feature for differentiating between the two groups was the morphologic features of the upstream MPD in relation to the cystic lesion or solid mass (sensitivity, 81.3%; specificity, 92.3%). CONCLUSION. Preoperative CT is helpful in differentiating two types of invasive carcinoma arising in association with IPMNs. These findings are clinically important because prognosis is better for colloid carcinoma than for tubular adenocarcinoma.
KW - CT
KW - Colloid carcinoma
KW - Invasive papillary mucinous neoplasm
KW - Pancreas
KW - Tubular adenocarcinoma
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U2 - 10.2214/AJR.19.21824
DO - 10.2214/AJR.19.21824
M3 - Article
C2 - 32130045
AN - SCOPUS:85083834095
SN - 0361-803X
VL - 214
SP - 1092
EP - 1100
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 5
ER -