A Case of Primary Pancreatic T-cell Lymphoma

Primary pancreatic lymphoma is a rare extranodal manifestation of any histopathologic subtype of non-Hodgkin's lymphoma that predominantly involves the pancreas, and it comprises less than 0.5% of all pancreatic malignancies. Histopathologically, most primary pancreatic lymphomas are the B-cell phenotypes, and T-cell lymphomas are extremely rare. We describe here the ultrasonography and computed tomography (CT) findings of a pathologically confirmed pancreatic T-cell lymphoma in a 37-year-old female patient. Ultrasonography showed diffuse pancreatic enlargement and a slightly bulging mass in the head and tail of pancreas that had markedly heterogeneous echogeneity. The lesion abutted onto the adjacent vessels, but there was no evidence of luminal narrowing or obstruction. The CT scan showed diffuse enlargement of the pancreas and the bulging contoured mass at the pancreatic head and tail with inhomogeneous enhancement, including multiple hypodense areas. It also showed the patent peripancreatic vessels and multiple LN enlargements around the pancreas.

A Case of Primary Pancreatic T-cell Lymphoma

Primary pancreatic lymphoma is a rare extranodal manifestation of any histopathologic subtype of non-Hodgkin's lymphoma that predominantly involves the pancreas, and it comprises less than 0.5% of all pancreatic malignancies. Histopathologically, most primary pancreatic lymphomas are the B-cell phenotypes, and T-cell lymphomas are extremely rare. We describe here the ultrasonography and computed tomography (CT) findings of a pathologically confirmed pancreatic T-cell lymphoma in a 37-year-old female patient. Ultrasonography showed diffuse pancreatic enlargement and a slightly bulging mass in the head and tail of pancreas that had markedly heterogeneous echogeneity. The lesion abutted onto the adjacent vessels, but there was no evidence of luminal narrowing or obstruction. The CT scan showed diffuse enlargement of the pancreas and the bulging contoured mass at the pancreatic head and tail with inhomogeneous enhancement, including multiple hypodense areas. It also showed the patent peripancreatic vessels and multiple LN enlargements around the pancreas.

Lymphoepithelial Cyst of the Pancreas: A Case Report

We present a case of lymphoepithelial cyst of the pancreas. The cyst showed moderate echogenicity, mimicking a solid lesion on ultrasonography (US), and had a cystic appearance on computed tomography (CT). This ambivalent finding may be a distinctive feature of lymphoepithelial cysts of the pancreas.

Extramedullary Plasmacytoma of the Pancreas: Imaging Findings: Case Report

Extramedullary plasmacytoma involves organs outside the bone marrow, but involvement of the pancreas is very rare. We present the imaging findings of extramedullary plasmacytoma of the pancreas in a patient with multiple myeloma. Mixed echogenecity was noted at US, and marked enhancement at CT and MR.

US and CT Imaging of Undifferentiated Carcinoma of the Pancreas

We report the case of a 64-year-old female patient with an undifferentiated carcinoma involving the pancreatic head in whom hepatic metastasis and encasement of the portal and superior mesenteric veins had occurred. Ultrasound demonstrated a round well-defined hypoechoic mass with increased color Doppler flow signals at the periphery, while CT revealed a heterogeneously enhanced mass with a less attenuated central portion and rim enhancement of the pancreatic head.

Lymphoepithelial Cyst of the Pancreas: A Case Report

Lymphoepithelial cyst of the pancreas is a very rare lesion of unknown etiology. It is difficult, on the basis of radiologic images, to differentiate between lymphoepithelial cyst and pancreatic pseudocyst or other cystic neoplasms, particularly if these are mucinous. We describe the sonographic and CT findings in a case of surgically proven lymphoepithelial cyst of the pancreas.

Radiologic Findings of the Serous Cystadenomas of the Pancreas with Macro cystic or Unilocular Variants: Comparison with the Pathologic Findings

PURPOSE: To evaluate the radiologic findings of the serous cystadenomas of the pancreas with macrocystic or unilocular variants and to compare them with the pathologic findings. MATERIALS AND METHODS: In eight patients(7 females and 1 male ranging in age from 26 to 49 [mean, 37] years) with surgically proven serous cystadenomas, the findings of abdominal CT(n=8), abdominal sonography(US, n=8), endoscopic retrograde pancreatography(ERCP, n=6), endoscopic sonography(EUS, n=3), and MRI(n=1) were evaluated. The location and size of tumors, lobulation, internal septa, solid component, calcification, communication with the pancreatic duct, dilatation of the proximal pancreatic duct, and contrast enhancement on CT were assessed and compared with the pathologic findings. RESULTS: Tumors were located in the head(n=3), body(n=3) and tail(n=2), and their mean size was 4 (range, 1 -8) cm. Abdominal CT scanning revealed well-defined cystic masses composed of macrocyst(s) with calcifica-tion(n=3) and dilatation of the proximal duct (n=2). Three cases showed contrast enhancement of the cystic walls, the pathologic examination of which revealed fibrotic tissues. Four tumeurs were unilocular without septation or lobulation; these features, together with calcification, were depicted more clearly by US and EUS. ERCP revealed no communication between the cysts and pancreatic ducts. Imaging studies showed that macrocystic adenomas were superimposed on mucinous cystadenomas, and unilocular adenomas were indis-tinguishable from pseudocysts. CONCLUSION: Serous cystadenomas of the pancreas with macrocystic or unilocular variants are common in middle-aged women. Features present due to the existence of fibrotic tissues, and which may be reveled by contrast-enhanced CT, include internal septa, calcification, duct dilation, and prominent enhancement of the cystic wall. Serous cystadenoma should be included in the differential diagnosis of macrocystic or unilocular cystic lesions of the pancreas.

Microadenocarcinoma of the Pancreas: US and CT Findings

Microadenocarcinoma of the pancreas is a very rare tumor, and we report one case of this malignancy.Sonography revealed a bulky mass with massive internal necrosis, while CT demonstrated a heterogeneously enhancedtumor with massive and irregularly marginated necrosis.

Acinar Cell Carcinoma of the Pancreas: A Case Report

Acinar cell carcinoma(ACC) of the pancreas is rare and usually presents as a metastasizing tumor with poorprognosis in elderly patients with non-specific symptoms. We describe a case of pancreatic acinar cell carcinomawith peritoneal spread and multiple liver metastases. Abdominal sonography showed a well-marginated echogenic masswith a large central anechoic necrotic portion; CT scanning showed a large mildly enhanced lobulated mass with alow attenuation center and thin rim-like capsular enhancement. Irregular peritumoral peritoneal extension withmultiple small low attenuation necrotic areas was also noted. Multiple small well-defined metastatic nodulesshowing low attenuation were scattered in the liver.

Lymphoepithelial Cyst of the Pancreas: A Report of 2 Cases

Two cases of lymphoepithelial cyst, a very rare cystic lesion of the pancreas, are reported. The patients complained of vague upper abdominal discomfort. One lesion was derived from the head of the pancreas, the other from its neck. Ultrasonographic finding of the former was a cystic lesion with inhomogeneous internal echogenecity, and in both cases, CT showed multiloculated cystic lesions with internal septa. Cysts filled with sebaceous material were excised on operation, and lymphoepithelial cyst was histopathologically confirmed.

Solid and Papillary Epithelial Neoplasm of the Pancreas: Radiologic-Pathologic Correlation

PURPOSE: To report variable radiologic manifestastions and to accomplish detailed radiologic-pathologic correlation of solid and papillary epithelial neoplasm of the pancreas. MATERIALS AND METHODS: In 23 patients with surgically confirmed solid and papillary epithelial neoplasm, retrospective examinations of operative records, gross and micropathologic findings, and radiologic findings including US(n=17), CT(n=23), ERCP(n=9), MRI(n=3) were carried out. On the basis of pathologic findings, detailed analysis of radiologic findings of solid and papillary epithelial neoplasm was then performed. RESULTS: Most pancreatic solid and papillary epithelialneoplasms(n=17) were seen as a mass with heterogeneous internal density consisting of cystic change, hemorrhagicnecrosis, and tumor tissue, although the mass can also be seen to be homogeneous(n=6). On gross specimens, acapsule which showed enhancement on the delayed phase of the enhanced CT scan was demonstrated in 22 cases. It was seen as an echogenic rim on the ultrasound images and as a low signal rim on the MR images. Calcification of themass was seen in ten cases, nine of which showed peripheral calcification along the tumor capsule ; five cases showed calcifications within the mass. On pathologic examination, ten cases had a single or multiple cystic appearance ; in seven of these cases, this appeared on CT scan. CONCLUSIONS: In addition to usual mixed internal density caused by hemorrhagic necrosis of the tumor, enhanced capsule and internal multicystic appearance on CT scan were other characteristics of pancreatic solid and papillary epithelial neoplasm. These could be useful findings in the radiologic approach and in the differential diagnosis of pancreatic masses.