Papillär neoplasi

Hem / Hälsa & Välmående / Papillär neoplasi

Primer of Diagnostic Imaging. AJR Am J Roentgenol. Eur J Radiol. (2003) ISBN: 0323023282 - Google Books

  • 2. Complete resection is curative.

    Main duct IPMN

    • chronic pancreatitis: can be difficult to distinguish from main duct type on account of dilated duct 5 but main duct strictures and pancreatic stones are far more common in chronic pancreatitis 22

    Branch-type IPMN

    The radiological report has to be clear regarding imaging worrisome features of these lesions that may guide further surgical intervention:

    • main duct type

      • main pancreatic duct over 5 mm

      • presence of contrast-enhancing components

    • branch duct type

      • main pancreatic duct over 5 mm

      • cyst diameter ≥3 cm

      • presence of a contrast-enhancing mural nodule ≥5 mm 16

      • presence of solid mass 16

      • thickened and enhancing cyst wall

      • growth rate ≥5 mm/year

    Clinical features to guide surgery may also include:

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    • 1.

      Salvia R, Fernández-del Castillo C, Bassi C et al.

      papillär neoplasi

      2012;12(2):414-21. Diffuse main duct type appears essentially indistinguishable from chronic pancreatitis, with duct dilatation and parenchymal atrophy 5.

      Mural nodules and mucin globules may appear hyperechoic and difficult to separate from adjacent pancreatic parenchyma 6.

      CT

      They present as single or multiple pancreatic cystic hypodense lesions.

      Ralph Weissleder, Jack Wittenberg, Mukesh G. Harisinghani. Castelli F, Bosetti D, Negrelli R et al. AJR Am J Roentgenol. Clinical presentation can predict disease course in patients with intraductal papillary mucinous neoplasm of the pancreas. Pancreatic Intraductal Papillary Mucinous Neoplasms: Role of CT in Predicting Pathologic Subtypes.

      serous cystadenomas).

      Fluoroscopy
      ERCP

      Direct imaging of the pancreatic duct demonstrates variable dilatation (segmental, diffuse, or branch) depending on the type. Försiktighet ska vidtas när semaglutid används till patienter med diabetesretinopati som behandlas med insulin. (See "Pancreatic cystic neoplasms: Clinical manifestations, diagnosis, and management".)

      EVALUATION FOR MALIGNANCY

      The evaluation of a patient with an intraductal papillary mucinous neoplasm (IPMN) aims to determine if the patient has or is at high-risk of developing a malignancy [3].

      Machado N, Al Qadhi H, Al Wahibi K. Intraductal Papillary Mucinous Neoplasm of Pancreas. doi:10.4103/1947-2714.157477 - Pubmed

    • 16. Gut. 2018;67(5):789-804. Om pankreatit fastställs, ska semaglutid inte sättas in igen. Cancer Imaging. doi:10.1259/bjr.20150853 - Pubmed citation
    • 15.

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      These tumors are most frequently identified in older patients, 50-60 years of age 6, and thus are sometimes colloquially referred to as the "grandfather lesion" 25.

      2021;12(1):1-26. Kawamoto S, Horton K, Lawler L, Hruban R, Fishman E. Intraductal Papillary Mucinous Neoplasm of the Pancreas: Can Benign Lesions Be Differentiated from Malignant Lesions with Multidetector CT? Radiographics. 2012;12 (3): 183-97.