1. To review neoplastic,
inflammatory and benign pancreatic,
as well as non-pancreatic processes that may closely simulate pancreatic adenocarcinoma (PA) 2. To provide imaging clues for the differentiation between PA and its mimickers
Pancreatic adenocarcinoma (PA) is one of the most aggressive malignancies,
ranking fourth among causes of cancer-related deaths in the Western world.
The accurate diagnosis of PA is of critical importance,
because the disease has a high mortality and its treatment has substantial morbidity. Tumor markers,
mainly CA 19-9,
and biopsy under EUS or CT guidance can assist in making the correct diagnosis but they have several drawbacks.
Whereas CA 19-9 is elevated in 81% of PA cases,
yet it cannot...
Findings and procedure details
BENIGN CONDITIONS FOCAL FATTY INFILTRATION Fatty infiltration of the pancreas can be focal or diffuse.
It is a benign procedure related with diabetes,
cystic fibrosis and other conditions.
Focal fatty infiltration is usually most prominent in the head of the pancreas and on contrast-enhanced CT it usually appears as an hypoenhanced region compared to the normal pancreatic tissue,
simulating PA. The key finding that leads to the correct diagnosis...
The depiction of an hypoattenuating lesion in the pancreatic head corresponds to an adenocarcinoma in the majority of cases.
radiologists must be cautious in diagnosing PA,
because false-positive diagnosis may lead to unnecessary surgery that is not free of complications. The correct diagnosis of benign conditions or other types of malignancy beyond PA with significantly better survival is important,
because it implies alternative therapeutic approaches.
Radiologists must be familiar...
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Mimics of pancreatic ductal adenocarcinoma. Cancer Imaging 2013;13(3):342-349.
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Kölblinger C et al.
Pancreatic adenocarcinoma. Eur Radiol 2007;17: 638.
doi: 10.1007/s00330-006-0435-7 3. Zamboni G,
Nonneoplastic mimickers of pancreatic neoplasms. Arch Pathol Lab Med 2009;133:439–453.