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Increased SI surrounding a complicated pseudocyst on T2FS.
Cause of inflammation is more likely to be chemical irritation than infection
Impossible to differentiate between an infectious process and other possible causes on the basis of imaging features alone.
Dissect along abdominopelvic fascial planes to sites remote from the pancreas
eg, liver, pleura, or mediastinum
Fistulation may occur between a pseudocyst and one or more vascular structures.
Pseudocysts No vascularized soft-tissue elements are present within pseudocysts, and if vascularized elements are seen within a cystic lesion on contrast-enhanced MR images, the lesion is not a pseudocyst.
Mucinous Nonneoplastic Cysts Mucin Containing Cyst DDx with mucinous cystadenomas. May be indistinguishable, especially if the cyst is large and has a thick wall. Mucinous cystadenomas Mucinous Nonneoplastic Cysts
Main pancreatic duct dilatation or dilatation of multiple side branches.
Adenocarcinoma in association with an IPMN.
Enhancing soft-tissue nodularity
Size more than 3.5 cm
Mucin Containing Cyst
Mucin Containing Cyst IPMN with involvement of the main pancreatic duct. . D iffuse dilatation of the main pancreatic duct with a focal cystic lesion . The lesion communicates with the distended main pancreatic duct .
Mucin Containing Cyst IPMN with involvement of the side-branches. F ocal dilatation of ductal side-branches in the pancreatic head .
Mucin Containing Cyst Invasive adenocarcinoma in association with an IPMN. A complex cystic lesion with ductal communication and enhancing soft tissue component.
DDx Contain enhancing soft tissue and cystic components:
Ductal Adenocarcinomas with Cystic Features.
Infiltrative pattern of the primary tumor.
Combined with ductal obstruction and vascular invasion
Cystic neoplasms such as solid pseudopapillary tumor and mucinous cystadenocarcinoma.
Solid Pancreatic Tumor with Cystic Degeneration
Solid Pancreatic Tumor with Cystic Degeneration Ductal adenocarcinoma with cystic changes. A poorly vascularized infiltrative tumor with a central necrosis and pseudocyst.
Solid Pancreatic Tumor with Cystic Degeneration Ductal adenocarcinoma with cystic changes. A pancreatic tumor obstructed pancreatic and common bile duct with distention of the pancreatic duct side-branches.
Solid Pancreatic Tumor with Cystic Degeneration A patient with a cystic neuroendocrine tumor is significantly more likely to have an underlying multiple endocrine neoplasia syndrome than a patient with a uniformly solid neuroendocrine tumor.
Cystic neuroendocrine tumor. A well define cyst with avidly enhancing thickening rim on arterial phase image. Solid Pancreatic Tumor with Cystic Degeneration
Which of the following statements does not accurately characterize cystic pancreatic neuroendocrine tumors?
A ) They are rarer than solid neuroendocrine tumors. B ) They are more commonly associated with multiple endocrine neoplasia than are solid neuroendocrine tumors. C ) They may include a vascularized soft-tissue component. D ) They usually demonstrate poor margination and an infiltrative growth pattern.