IPMN: Exocrine, mucin-producing, cystic pancreatic neoplasm arising from pancreatic ducts
BD-IPMN: Neoplastic infiltration of side-branch epithelia with uni- or multilocular cystic dilation; moderate risk of malignancy
MD-IPMN: Neoplastic proliferation of main duct epithelia exhibiting segmental or diffuse dilation of MPD; high risk of malignancy
MT-IPMN: Characteristics of both main and branch duct types; high risk of malignancy
MCN: Nonductal, cystic, mucinous neoplasm with ovarian-type stroma affecting almost exclusively women; moderate risk of malignancy
SCN: Benign, cystic, serous neoplasm
SPN: Rare, solid-cystic neoplasm of exocrine pancreas with heterogeneous aspects due to cystic, hemorrhagic, or necrotic degeneration affecting almost exclusively young women; low risk of malignancy
Cystic PNET: ~ 10% of PNETs are cystic due to central necrosis
Further nonneoplastic cysts include broad variety of different entities, including simple dysontogenetic cysts
Pseudocyst: Most common cystic lesion of pancreas as consequence of necrosis in course of acute or chronic pancreatitis
CLINICAL IMPLICATIONS
Clinical Importance
IMAGING
General Anatomic Considerations
Critical Anatomic Structures
Role of CEUS
Selected References
European Study Group on Cystic Tumours of the Pancreas: European evidence-based guidelines on pancreatic cystic neoplasms. Gut. 67(5):789-804, 2018
Vinik A et al: Pathophysiology and treatment of pancreatic neuroendocrine tumors (PNETs): New developments. https://www.ncbi.nlm.nih.gov/books/NBK279074/. Updated June 2018. Accessed November 2018
Marchegiani G et al: Systematic review, meta-analysis, and a high-volume center experience supporting the new role of mural nodules proposed by the updated 2017 international guidelines on IPMN of the pancreas. Surgery. 163(6):1272-1279, 2018
Dietrich CF et al: Serous pancreatic neoplasia, data and review. World J Gastroenterol. 23(30):5567-5578, 2017
Tanaka M et al: Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology. 17(5):738-753, 2017
Nilsson LN et al: Nature and management of pancreatic mucinous cystic neoplasm (MCN): A systematic review of the literature. Pancreatology. 16(6):1028-1036, 2016
Tyberg A et al: Management of pancreatic fluid collections: A comprehensive review of the literature. World J Gastroenterol. 22(7):2256-70, 2016
D'Onofrio M et al: Imaging and Pathology of Pancreatic Neoplasms: A Pictorial Atlas. Springer, 2015
Fan Z et al: Application of contrast-enhanced ultrasound in cystic pancreatic lesions using a simplified classification diagnostic criterion. Biomed Res Int. 2015:974621, 2015
Jenssen C et al: Management of incidental pancreatic cystic lesions. Viszeralmedizin. 31(1):14-24, 2015
Jiang L et al: Solid pseudopapillary tumors of the pancreas: Findings from routine screening sonographic examination and the value of contrast-enhanced ultrasound. J Clin Ultrasound. 43(5):277-82, 2015
D'Onofrio M: Ultrasonography of the Pancreas: Imaging and Pathologic Correlations. Springer, 2012
D'Onofrio M et al: Pancreatic multicenter ultrasound study (PAMUS). Eur J Radiol. 81(4):630-8, 2012
Xu M et al: The application value of contrast-enhanced ultrasound in the differential diagnosis of pancreatic solid-cystic lesions. Eur J Radiol. 81(7):1432-7, 2012
Beyer-Enke SA et al: Contrast enhanced transabdominal ultrasound in the characterisation of pancreatic lesions with cystic appearance. JOP. 11(5):427-33, 2010
D'Onofrio M et al: Imaging techniques in pancreatic tumors. Expert Rev Med Devices. 7(2):257-73, 2010
D'Onofrio M et al: Comparison of contrast-enhanced sonography and MRI in displaying anatomic features of cystic pancreatic masses. AJR Am J Roentgenol. 189(6):1435-42, 2007
Sahani DV et al: Cystic pancreatic lesions: a simple imaging-based classification system for guiding management. Radiographics. 25(6):1471-84, 2005
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Clinical Implications
IMAGING
TERMINOLOGY
Abbreviations
Pancreatic cystic lesion (PCL)
Intraductal papillary mucinous neoplasm (IPMN)
Branch duct type (BD)
Main duct type (MD)
Mixed type (MT)
Mucinous cystic neoplasm (MCN)
Serous cystic neoplasm (SCN)
Solid pseudopapillary neoplasm (SPN)
Pancreatic neuroendocrine tumor (PNET)
Definitions
IPMN: Exocrine, mucin-producing, cystic pancreatic neoplasm arising from pancreatic ducts
BD-IPMN: Neoplastic infiltration of side-branch epithelia with uni- or multilocular cystic dilation; moderate risk of malignancy
MD-IPMN: Neoplastic proliferation of main duct epithelia exhibiting segmental or diffuse dilation of MPD; high risk of malignancy
MT-IPMN: Characteristics of both main and branch duct types; high risk of malignancy
MCN: Nonductal, cystic, mucinous neoplasm with ovarian-type stroma affecting almost exclusively women; moderate risk of malignancy
SCN: Benign, cystic, serous neoplasm
SPN: Rare, solid-cystic neoplasm of exocrine pancreas with heterogeneous aspects due to cystic, hemorrhagic, or necrotic degeneration affecting almost exclusively young women; low risk of malignancy
Cystic PNET: ~ 10% of PNETs are cystic due to central necrosis
Further nonneoplastic cysts include broad variety of different entities, including simple dysontogenetic cysts
Pseudocyst: Most common cystic lesion of pancreas as consequence of necrosis in course of acute or chronic pancreatitis
CLINICAL IMPLICATIONS
Clinical Importance
IMAGING
General Anatomic Considerations
Critical Anatomic Structures
Role of CEUS
Selected References
European Study Group on Cystic Tumours of the Pancreas: European evidence-based guidelines on pancreatic cystic neoplasms. Gut. 67(5):789-804, 2018
Vinik A et al: Pathophysiology and treatment of pancreatic neuroendocrine tumors (PNETs): New developments. https://www.ncbi.nlm.nih.gov/books/NBK279074/. Updated June 2018. Accessed November 2018
Marchegiani G et al: Systematic review, meta-analysis, and a high-volume center experience supporting the new role of mural nodules proposed by the updated 2017 international guidelines on IPMN of the pancreas. Surgery. 163(6):1272-1279, 2018
Dietrich CF et al: Serous pancreatic neoplasia, data and review. World J Gastroenterol. 23(30):5567-5578, 2017
Tanaka M et al: Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology. 17(5):738-753, 2017
Nilsson LN et al: Nature and management of pancreatic mucinous cystic neoplasm (MCN): A systematic review of the literature. Pancreatology. 16(6):1028-1036, 2016
Tyberg A et al: Management of pancreatic fluid collections: A comprehensive review of the literature. World J Gastroenterol. 22(7):2256-70, 2016
D'Onofrio M et al: Imaging and Pathology of Pancreatic Neoplasms: A Pictorial Atlas. Springer, 2015
Fan Z et al: Application of contrast-enhanced ultrasound in cystic pancreatic lesions using a simplified classification diagnostic criterion. Biomed Res Int. 2015:974621, 2015
Jenssen C et al: Management of incidental pancreatic cystic lesions. Viszeralmedizin. 31(1):14-24, 2015
Jiang L et al: Solid pseudopapillary tumors of the pancreas: Findings from routine screening sonographic examination and the value of contrast-enhanced ultrasound. J Clin Ultrasound. 43(5):277-82, 2015
D'Onofrio M: Ultrasonography of the Pancreas: Imaging and Pathologic Correlations. Springer, 2012
D'Onofrio M et al: Pancreatic multicenter ultrasound study (PAMUS). Eur J Radiol. 81(4):630-8, 2012
Xu M et al: The application value of contrast-enhanced ultrasound in the differential diagnosis of pancreatic solid-cystic lesions. Eur J Radiol. 81(7):1432-7, 2012
Beyer-Enke SA et al: Contrast enhanced transabdominal ultrasound in the characterisation of pancreatic lesions with cystic appearance. JOP. 11(5):427-33, 2010
D'Onofrio M et al: Imaging techniques in pancreatic tumors. Expert Rev Med Devices. 7(2):257-73, 2010
D'Onofrio M et al: Comparison of contrast-enhanced sonography and MRI in displaying anatomic features of cystic pancreatic masses. AJR Am J Roentgenol. 189(6):1435-42, 2007
Sahani DV et al: Cystic pancreatic lesions: a simple imaging-based classification system for guiding management. Radiographics. 25(6):1471-84, 2005
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