Lesson 3B (Part 2) Flashcards
Are cystic neoplasms benign or malignant?
Both
- good patient history is important to help differentiate
What do the majority of pseudocysts have?
Cystic lesions
- > 75%
What are some imaging features to help with differential diagnosis?
CT and MRI are not reliable when charaterizing when small
- importance of US is to follow patients with cysts 3cm or less in diameter
What are high-risk features of cystic pancreatic lesions? (5)
- Symptomatic Patients
- Growth on serial examinations
- Diameter >3cm
- Internal soft tissue
- Mural or septal thickening
Where are simple cysts rare?
In the pancreas
What are examples of inherited diseases with a high prevalence of cysts? (2)
- Polycystic Kidney Disease
- ADPKD - Von Hippel-Lindau Disease
- VHL
Von Hippel-Lindau Disease
Is a connective tissue disorder
What does multiple simple pancreatic cysts suggest?
VHL
What are 3 lesions associated with VHL?
- Serous cystic neoplasm
- Pancreatic endocrine tumors
- Ductal adenocarcinoma
Why do you use colour doppler on a benign cyst in the pancreatic tail?
To differentiate from a tortuous splenic artery
What are cystic tumours normally?
Benign or low grade malignancies
Are mucinous tumours often benign or malignant?
Malignant
Who has a great risk for mucinous tumours?
Older individuals
What is the most common cystic neoplasms in order of prevalence? (4)
- Serous cystic
- Intraductal papillary mucinous
- Mucinous cystic
- Solid pseudopapillary
What was serous cystic neoplasm previously known as?
Microcystic adenoma
Microcystic adenoma
Is a benign tumor that is more frequently found in women that most often occurs in the pancreatic head
Whats does serous cystic neoplasm look like sonographically?
- Myriad of tiny cysts
- too small to be resolved individually with US - Echogenic appearance
- due to multiple reflective wall interfaces - Posterior enhancement
- Fibrous pattern may be present
- Central calcification
- 30-50% of the time
IPMN
Intraductal papillary mucinous neoplasm
What are 3 other names for intraductal papillary mucinous neoplasm?
- Intraductal papillary mucinous tumor
- Intraductal mucin-hyperfunctioning neoplasm
- Ductectatic mucinous neoplasm
Where does IPMN arise from?
The pancreatic ducts
- head region usually
Who does IPMN affect more?
The elderly
- men and women equally
How does IPMN persist?
As acute pancreatitis
Why does IPMN persist as acute pancreatitis?
Due to mucin being secreted into ducts
- duct dilation and sometimes
Mucin travels to ampulla of Vater
Is IPMN benign or malignant?
Can be either
