The value of calcification and cystic lesion of CT findings in differentiating pancreatic head ductal carcinoma from mass-forming chronic pancreatitis of the pancreatic head / 实用放射学杂志

Objective To investigate the diagnostic value of calcification and cystic lesion of CT findings in differentiating pancreatic head ductal carcinoma (PHDA)from mass-forming chronic pancreatitis (MFCP)of the pancreatic head.Methods The clinic data and CT findings of 30 cases with PHDA and 24 cases with MFCP of the pancreatic head,which were confirmed by surgery and pathology were analyzed retrospectively.The images were reviewed independently by two expert radiologists with a double-blind method.An independent sample t test and chi-square test were used to compare the data of imaging findings between two groups.Results ① Calcification was found in 14 cases (58.33%)with MFCP and in 3 cases (10%)with PHDA (P＜0.001).The percentage of patchy,punctate and mixed calcification were 28.57% (n=4),14.29% (n=2)and 57.14% (n=8)in MFCP,0% (n=0),66.67% (n=2)and 33.33% (n=1) in PHDA,respectively.② Necrotic cyst was founded in 7 cases (29.17%)with MFCP and 18 cases (60%)with PHDA(P＜0.05). Pseudocysts were demonstrated in 14 cases (58.33%)with MFCP and in 3 cases (10%)with PHDA (P＜0.001).Honeycombed change with tension within or around the lesion were demonstrated only in patients with MFCP.In addition,normal tissue of the pancreas was found within the lesion in 11 cases (45.83%)of MFCP and none in PHDA,which showed significant difference between two groups.Conclusion Mixed calcification and honeycomb with tension of CT findings are of significant value in differentiating PHDA from MFCP of the pancreatic head.

Pancreatic carcinogenesis: The impact of chronic pancreatitis and its clinical relevance.

Pancreatic cancer is a devastating disease with a dismal prognosis and early detection remains a challenge. On the background that inflammation is one of the key steps in the development of cancer, it is natural that chronic pancreatitis is considered as one of the etiological factors for the development of pancreatic cancer. However, the process of pancreatic carcinogenesis is a multifactorial phenomenon rather than a process that evolves solely via inflammation. This review attempts to put into perspective the association between different etiological forms of chronic pancreatitis and pancreatic cancer, and the diverse mechanisms operational in the process of pancreatic carcinogenesis. Furthermore, the clinical relevance of the current understanding of the relationship between chronic pancreatitis and pancreatic cancer, especially with regard to the pancreatic head mass of uncertain etiology, is discussed in this review.