Abstract
Objective: To characterize the multi-slice spiral computed tomographic (MSCT) findings and clinicopathology of solid pseudopapillary tumor (SPT) in the pancreas.Methods: The MSCT images of 24 patients with pathologically and immunohistochemically identified SPTs were reviewed.Tumor location, size, contour, boundary, enhancement patterns, degree of enhancement, percentage of necrosis, and calcification of the tumors were observed.The invasion to the adjacent organs and structures and lymph node metastases were analyzed.Results: (1) Of the 24 patients whose MSCT scan images were reviewed, 10 had SPTs in the head of the pancreas, 7 in the body of the pancreas, 6 in the tail of the pancreas, and 1 bestride the body and the tail of the pancreas.(2) There were solid and cystic structures within the neoplasms.The cystic portions appeared hypo-attenuation on both pre-and post-contrast views.The solid portions demonstrated hypo-or iso-attenuation on pre-contrast MSCT scans, slight or midrange enhancement in the arterial phase and marked enhancement in the portal venous phase on post-contrast MSCT scans.The maximal density con- trast beween the solid portions and the pancreatic tissues could be observed in the arterial phase.(3) Six lesions were mainly composed of cystic structures and their solid portions under the capsule appeared as mural nodules.Eight lesions were mainly composed of solid structures with cystic portions near or under the capsule, and 10 lesions were composed of similar proportions of cystic and solid parts distributed alternatively. (4) Eight lesions had calcification within the tumors, 6 lesions were accompanied with associated dilatation of the pancreatic duct, and 1 lesion was accompanied with dilatation of the common bile duct and intrahepatic bile ducts.(5) Nine tumors had malignant tendency, one of which displayed diffused growth.Five lesions were circumvoluted with the blood vessels of the spleen, 2 tumors adhered to the blood vessels of the mesentery, and 1 tumor was circumvoluted with the vena renalis dextra.Other tumors with complete capsules and without invasion to the adjacent organs and structures were diagnosed as benign.There were a few differences between the surgical findings and MSCT scans.Conclusion: The MSCT of SPTs has distinct features and is helpful for the prediction of the malignant risk of SPTs in the pancreas.
Published Version
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