Pancreas - Part 4

Question 1

What are clinical findings of a pancreatic cyst? (3)

Answer 1

1. Asymptomatic
2. Dyspepsia
3. Jaundice

Question 2

What is the US appearance of pancreatic cyst? (3)

Answer 2

1. Anechoic mass
2. Smooth borders
3. Posterior acoustic enhancement

Question 3

What are 3 differential diagnosis of a pancreatic cyst?

Answer 3

1. Fluid-filled stomach 2. Pseudocyst

3. Polycystic disease

Question 4

What are causes of cystadenoma? (2)

Answer 4

1. Microcystic
   - accounts for 50% of cystic neoplasms involving the pancreas
2. Macrocystic
   - arise from the ducts
   - malignant potential

Question 5

What are the clinical findings of cystadenoma? (4)

Answer 5

1. Asymptomatic
2. Abdominal pain
3. Palpable mass
4. Weight loss

Question 6

What is the microcystic US appearance of cystadenoma? (2)

Answer 6

1. Echogenic

2. Complex mass

Question 7

What are 4 differential diagnosis of cystadenoma?

Answer 7

1. Pseudocyst
2. Polycystic disease 3. Abscess
3. Fluid-filled stomach

Question 8

Is a cystadenoma more common in males or females?

Answer 8

Females

Question 9

What is the macrocystic US appearance of cystadenoma? (4)

Answer 9

1. Multiloculated cystic mass
2. Irregular margins
3. Solid nodules
4. Displacement of the CBD, pancreatic duct, and splenic vein may occur

Question 10

Where is the majority of cystadenoma located?

Answer 10

In the body and tail of the pancreas

Question 11

What is polycystic disease associated with? (2)

Answer 11

1. Polycystic liver

2. Kidney disease

Question 12

What are the clinical findings of a polycystic disease? (2)

Answer 12

1. Asymptomatic

2. Abdominal pain

Question 13

What is the US appearance of a polycystic disease? (2)

Answer 13

1. Multiple cysts
2. Associated with multiple cysts in
   the liver, kidney, or spleen

Question 14

What are 3 differential diagnosis of polycystic disease?

Answer 14

1. True cyst
2. Fluid-filled loops of
   bowel
3. Cystadenoma

Question 15

What is the 4th most common malignancy?

Answer 15

Carcinoma of the pancreas

Question 16

What is the cause of pancreatic carcinoma?

Answer 16

Adenocarcinoma

Question 17

Where is the most common place of a pancreatic carcinoma?

Answer 17

Head of the pancreas

- the body is the next common place

Question 18

What are the clinical findings of pancreatic carcinoma? (6)

Answer 18

1. Abdominal pain
2. Severe back pain
3. Weight loss
4. Painless jaundice
5. Anorexia
6. New onset of diabetes

Question 19

What is the US appearance of pancreatic carcinoma? (6)

Answer 19

1. Hypo echoic mass in the pancreas
2. Irregular borders
3. Dilated biliary tree
4. Hydropic GB
5. Liver metastasis
6. Ascites

Question 20

What are 3 differential diagnosis of pancreatic carcinoma?

Answer 20

1. Focal pancreatitis
2. Adenoma
3. Caudate lobe of the liver

Question 21

What are 2 types of functional Islet cell tumours?

Answer 21

1. Insulinoma

2. Gastrinoma

Question 22

How much of nonfunctional Islet cell tumour are malignant?

Answer 22

90%

Question 23

What are the clinical findings of an insulinoma? (5)

Answer 23

1. Increase in insulin levels
2. Hypoglycemia
3. Headaches
4. Obesity
5. Confusion

Question 24

What are the clinical findings of an gastrinoma?

Answer 24

Gastric hyperstimulation associated with peptic ulcer disease

Question 25

What is the Islet cell tumour US appearance? (5)

Answer 25

1. Small, well-defined hypo echoic mass 2. Large tumours are more echogenic 3. Calcifications 4. Necrotic cystic areas are more likely malignant 5. Majority are hypervascular

Question 26

What are 3 differential diagnosis of Islet cell tumours?

Answer 26

1. Adenoma 2. Carcinoma 3. Complex cyst

Question 27

Where are Islet cell tumours most commonly located?

Answer 27

Body or tail

Question 28

Demonstration of the pancreatic head surrounding the duodenum is consistent with

Answer 28

An annular pancreas

Question 29

What is the most common complication associated with acute pancreatitis?

Answer 29

Pseudocyst

Question 30

Where do Islet cells of Langerhans secrete hormones directly into?

Answer 30

The bloodstream

Question 31

In a Whipple procedure, where does normal pancreatic tissue attached to?

Answer 31

The duodenum

Question 32

What is the most common cause of acute pancreatitis?

Answer 32

Biliary disease

Question 33

Is majority of nonfunctioning islet cell tumours benign or malignant?

Answer 33

Malignant

Question 34

What is the anechoic structure located in the lateral portion of the pancreatic head?

Answer 34

CBD

Question 35

A sheath of muscle fibers surrounding the distal CBD describes the

Answer 35

Sphincter of Oddi