Serous cystadenoma of the pancreas: report of 30 cases with emphasis on the imaging findings.

PURPOSE: Our goal was to evaluate retrospectively 30 cases of serous cystadenoma (SCA) to determine its main imaging features as well as to discuss the differential diagnosis problems versus the other cystic lesions of the pancreas. METHOD: Thirty SCAs were analyzed; they were all benign lesions, proven at surgery. Twenty-three tumors were evaluated with US, 26 with CT, and 5 with MRI. RESULTS: Three different morphostructural patterns were identified: microlacunar (n = 19), mixed (n = 6), and macrolacunar (n = 5). The diagnosis of SCA, possible in either the microlacunar or the mixed patterns, was achieved in 74% of cases with US (17/23) and in 61.5% with CT (16/26). Among the 19 patients evaluated with both modalities, the joint information allowed a correct diagnosis in 16 cases (84%). The five macrolacunar tumors were undistinguishable from other cystic masses of the pancreas. CONCLUSION: The diagnosis of SCA can be considered certain in the microlacunar, likely in the mixed, and not possible in the macrolacunar type.

[Imaging of bronchogenic cysts]. / L'imaging delle cisti broncogene.

Bronchogenic cysts, unlike the other mediastinal cysts, exhibit a high incidence of complications, which makes their resection advisable even if no symptoms are present. The correct diagnosis should thus be made with the available imaging modalities. We reviewed our series of 11 bronchogenic cysts, all of them studied with conventional radiology (CR), as well as with such newer imaging modalities as CT and/or MRI. All mediastinal lesions had fluid density at CT and were homogeneously hyperintense on T2-weighted MR images. On the contrary, on T1-weighted images, some lesions were hypointense and some hyperintense, probably because of their rich protein content. In contrast, hilar or pulmonary lesions had air inside, except for one case--characterized by multiple localizations--in which the hilar lesion exhibited the same fluid density as the mediastinal lesions. The CT or MR finding of a lesion with fluid content below the carina permits a nearly unquestionable diagnosis of bronchogenic cyst since the other cystic lesions involve this region very rarely. In all the other cases, other types of mediastinal or hilar-pulmonary lesions cannot be ruled out. In particular, in case of cysts in paraesophageal site, no imaging modality permits to differentiate bronchogenic from enteric cysts; in some cases, the differential diagnosis may be impossible even with histology of the resected specimen.