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Gastrointestinal Imaging

E2845. Beyond Adenocarcinoma: Uncommon Solid Lesions of the Pancreas

Chen F,  Romero M,  Cheng P,  Gulati M,  Duddalwar V. University of Southern California, Los Angeles, CA

Address correspondence to F. Chen (frank.chen@med.usc.edu)

Background Information: Pancreatic adenocarcinoma accounts for approximately 85–90% of pancreatic neoplasms; however, many less common solid pancreatic masses exist and including these in the differential diagnosis when appropriate can impact prognosis and treatment. To recognize these entities, radiologists must familiarize themselves with relevant findings.

Educational Goals/Teaching Points: The goal of this exhibit is to discuss the characteristic imaging and clinical features of uncommon solid pancreatic masses. We will present multimodality case examples with relevant pearls and pitfalls. -We will also provide the reader with the tools to formulate an appropriate differential diagnosis when reporting solid pancreatic masses.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: This exhibit will review several types of solid pancreatic masses. These include: exocrine neoplasms (solid pseudopapillary tumor), endocrine neoplasms (functional and nonfunctional neuroendocrine tumors), mesenchymal neoplasms (giant cell and granulosa cell tumors), lymphoproliferative disease (lymphoma, plasmacytoma, and Castleman Disease), secondary tumors (hyper and hypovascular metastases), parapancreatic tumors (gastrointestinal stromal tumor and angiosarcoma), and nonneoplastic masses (pancreatitis, including necrotizing, autoimmune, hemorrhagic, and groove pancreatitis, intrapancreatic accessory spleen, and fatty infiltration and replacement).

Conclusion: The differential diagnosis for a solid pancreatic mass is broad and includes many lesser known entities. Knowledge of clinical and imaging features of these lesions is critical to ensure accurate characterization and diagnosis.