ISSN 1305-3825 | E-ISSN 1305-3612
Abdominal Imaging - Pictorial Essay
Pancreas ductal adenocarcinoma with cystic features on cross-sectional imaging: radiologic-pathologic correlation
1 Department of Radiology, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, South Korea  
2 Department of Radiology,Department of Hepato-Biliary-Pancreatic Cancer Center, Seoul St. Mary’s Hospital; Cancer Research Institute, The Catholic University of Korea College of Medicine, Seoul, Korea.  
3 Department of Hepato-Biliary-Pancreatic Cancer Center, Department of Hospital Pathology, Seoul St. Mary’s Hospital; Cancer Research Institute, The Catholic University of Korea College of Medicine, Seoul, Korea.  
4 Department of Hepato-Biliary-Pancreatic Cancer Center, Department of Internal Medicine, Seoul St. Mary’s Hospital; Cancer Research Institute, The Catholic University of Korea College of Medicine, Seoul, Korea  
Diagn Interv Radiol ; : -

Abstract

Most pancreatic ductal adenocarcinomas (PDAs) show solid growth pattern, but ductal adenocarcinomas may demonstrate intratumoral cystic appearance or accompany peritumoral non-neoplastic cystic lesions, thus mimicking cystic pancreatic tumors on imaging studies. The histopathologic findings for PDA with cystic feature are divided into neoplastic and non-neoplastic cysts. Neoplastic cystic changes include large-duct type cysts (microcystic appearance), neoplastic mucin cysts (macrocystic appearance), colloid carcinomas (mucinous noncystic adenocarcinomas) and degenerative cystic change usually caused by hemorrhagic necrosis of tumor. Non-neoplastic cystic changes include retention cysts caused by ductal obstruction and pseudocysts caused by tumor-associated pancreatitis. Depending on the presence, size, number and configuration of cystic changes, PDA should be differentiated from various types of cystic neoplasms. This review provides histopathologic classification of PDAs with cystic features along with the corresponding cross-sectional imaging findings, and differential diagnosis of each pathologic type of cystic features.

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