Ishigami K, Nishie A, Asayama Y, Ushijima Y, Takayama Y, Fujita N, Takahata S, Ohtsuka T, Ito T, Igarashi H, Ikari S, Metz CM, Honda H. Imaging pitfalls of pancreatic serous cystic neoplasm and its potential mimickers. World J Radiol 2014; 6(3): 36-47 [PMID: 24765239 DOI: 10.4329/wjr.v6.i3.36]
Corresponding Author of This Article
Kousei Ishigami, MD, PhD, Visiting Associate Professor, Department of Radiology, University of Iowa Hospitals and Clinics, 3885 JPP, 200 Hawkins Drive, Iowa City, IA 52242, United States. Ishigamikousei@aol.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Kousei Ishigami, Catherine M Metz, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States
Akihiro Nishie, Yoshiki Asayama, Yasuhiro Ushijima, Yukihisa Takayama, Nobuhiro Fujita, Hiroshi Honda, Department of Clinical Radiology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Japan
Shunichi Takahata, Takao Ohtsuka, Department of Surgery and Oncology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Tetsuhide Ito, Hisato Igarashi, Department of Medicine and Bioregulatory Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
Shuji Ikari, Department of Internal Medicine, Hokkaido Gastroenterology Hospital, Sapporo 065-0041, Japan
Author contributions: All authors substantially contributed to the clinical study, acquisition of the data, interpretation of the data, and providing of cases; Ishigami K wrote the manuscript and played a major role in image selection; Honda H and Nishie A critically revised the article for important intellectual content.
Correspondence to: Kousei Ishigami, MD, PhD, Visiting Associate Professor, Department of Radiology, University of Iowa Hospitals and Clinics, 3885 JPP, 200 Hawkins Drive, Iowa City, IA 52242, United States. Ishigamikousei@aol.com
Telephone: +1-319-3561071 Fax: +1-319-3562220
Received: November 12, 2013 Revised: February 11, 2014 Accepted: March 3, 2014 Published online: March 28, 2014 Processing time: 157 Days and 9.7 Hours
Abstract
The aim of this article is to clarify diagnostic pitfalls of pancreatic serous cystic neoplasm (SCN) that may result in erroneous characterization. Usual and unusual imaging findings of SCN as well as potential SCN mimickers are presented. The diagnostic key of SCN is to look for a cluster of microcysts (honeycomb pattern), which may not be always found in the center. Fibrosis in SCN may be mistaken for a mural nodule of intraductal papillary mucinous neoplasm (IPMN). The absence of cyst wall enhancement may be helpful to distinguish SCN from mucinous cystic neoplasm. However, oligocystic SCN and branch duct type IPMN may morphologically overlap. In addition, solid serous adenoma, an extremely rare variant of SCN, is difficult to distinguish from neuroendocrine tumor.
Core tip: Most serous cystic neoplasm (SCN) consist of a combination of microcystic, macrocystic, and solid-appearing components. The imaging appearance of each component simply reflects the different sizes of cysts that comprise the SCN. The diagnostic key of SCN is to look for a cluster of microcysts (honeycomb pattern). However, differentiation between oligocystic SCN and branch duct type intraductal papillary mucinous neoplasm, and between neuroendocrine tumor and extremely rare solid serous adenoma, may be difficult.
