Abdominal Imaging - Original Article
Solid pseudopapillary neoplasm of the pancreas: CT imaging features and radiological-pathological correlation
Department of Diagnostic Imaging, National University Hospital, Singapore; Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Department of Diagnostic Imaging, National University Hospital, Singapore.
Department of Pathology, National University Hospital, Singapore and Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Diagn Interv Radiol ; : -
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Purpose: To evaluate the imaging features of solid pseudopapillary neoplasm (SPN) of the pancreas with an emphasis on radiological-pathological correlation.
Materials and method: Ten patients (all female, average age 32 years) with histological/ cytological diagnosis of SPN encountered between Jan 2007 and Dec 2013 were included in this study. Pre-operative CT images were reviewed for location, attenuation, enhancement pattern, margin, shape, size, morphology, presence of capsule and calcification. CT appearances were correlated with histopathological findings.
Results: Tumours in the distal pancreatic body and tail had a tendency to be larger (mean size 12.6 cm vs. 4.0 cm). Six of the nine tumours that were resected had a fibrous pseudocapsule at histology; it could be identified on CT scan in five of them. Eight lesions had mixed hypo-enhancing solid components and cystic areas corresponding to tumour necrosis and haemorrhage. The two smallest lesions were purely solid and non-encapsulated. Varied patterns of calcification were seen in four tumours. Three of the four pancreatic tail tumours invaded the spleen. At a median follow up of 53 months, there was no evidence of recurrence in the nine patients who underwent surgical resection of the tumour.
Conclusion: A mixed solid and cystic pancreatic mass in a young woman is suggestive of SPN. However, smaller lesions may be completely solid. Splenic invasion can occur in pancreatic tail SPNs; however, in this series it did not adversely affect the long term outcome.