D'Onofrio Mirko, De Robertis Riccardo, Capelli Paola, Tinazzi Martini Paolo, Crosara Stefano, Gobbo Stefano, Butturini Giovanni, Salvia Roberto, Barbi Emilio, Girelli Roberto, Bassi Claudio, Pederzoli Paolo
Department of Radiology, G.B. Rossi Hospital, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy,
Abdom Imaging. 2015 Aug;40(6):1629-44. doi: 10.1007/s00261-015-0388-x.
Pancreatic neoplasms are a wide group of solid and cystic lesions with different and often characteristic imaging features, clinical presentations, and management. Among solid tumors, ductal adenocarcinoma is the most common: it arises from exocrine pancreas, comprises about 90% of all pancreatic neoplasms, and generally has a bad prognosis; its therapeutic management must be multidisciplinary, involving surgeons, oncologists, gastroenterologists, radiologists, and radiotherapists. The second most common solid pancreatic neoplasms are neuroendocrine tumors: they can be divided into functioning or non-functioning and present different degrees of malignancy. Cystic pancreatic neoplasms comprise serous neoplasms, which are almost always benign, mucinous cystic neoplasms and intraductal papillary mucinous neoplasms, which can vary from benign to frankly malignant lesions, and solid pseudopapillary tumors. Other pancreatic neoplasms, such as lymphoma, metastases, or pancreatoblastoma, are rarely seen in clinical practice and have different and sometimes controversial managements. Rare clinical presentations and imaging appearance of the most common pancreatic neoplasms, both solid and cystic, are more frequently seen and clinically relevant than rare pancreatic tumors; their pathologic and radiologic appearances must be known to improve their management. The purpose of this paper is to present some rare or uncommon clinical and radiological presentations of common pancreatic neoplasms providing examples of multi-modality imaging approach with pathologic correlations, thus describing the histopathological bases that can explain the peculiar imaging features, in order to avoid relevant misdiagnosis and to improve lesion management.
胰腺肿瘤是一大类实性和囊性病变，具有不同且往往具有特征性的影像学特征、临床表现和治疗方法。在实性肿瘤中，导管腺癌最为常见：它起源于外分泌胰腺，约占所有胰腺肿瘤的90%，通常预后不良；其治疗必须多学科进行，涉及外科医生、肿瘤学家、胃肠病学家、放射科医生和放疗科医生。第二常见的实性胰腺肿瘤是神经内分泌肿瘤：它们可分为功能性或非功能性，具有不同程度的恶性程度。胰腺囊性肿瘤包括几乎总是良性的浆液性肿瘤、黏液性囊性肿瘤和导管内乳头状黏液性肿瘤，后者可从良性病变到明显恶性病变不等，以及实性假乳头状肿瘤。其他胰腺肿瘤，如淋巴瘤、转移瘤或胰腺母细胞瘤，在临床实践中很少见，其治疗方法也各不相同，有时存在争议。最常见的实性和囊性胰腺肿瘤的罕见临床表现和影像学表现比罕见胰腺肿瘤更常见且具有临床相关性；必须了解它们的病理和影像学表现以改善其治疗。本文的目的是介绍一些常见胰腺肿瘤的罕见或不常见临床和放射学表现，并提供多模态成像方法与病理相关性的示例，从而描述可解释特殊影像学特征的组织病理学基础，以避免相关误诊并改善病变管理。
