Youn Seo Yeon, Rha Sung Eun, Jung Eun Sun, Lee In Seok
Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine; Hepato-Biliary-Pancreatic Cancer Center, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine; Cancer Research Institute, The Catholic University of Korea College of Medicine, Seoul, South Korea.
Diagn Interv Radiol. 2018 Jan-Feb;24(1):5-11. doi: 10.5152/dir.2018.17250.
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 pictorial essay provides histopathologic classification of PDAs with cystic features along with the corresponding cross-sectional imaging findings, and their differential diagnosis.
大多数胰腺导管腺癌（PDA）呈实性生长模式，但导管腺癌可能表现出肿瘤内囊性外观或伴有肿瘤周围非肿瘤性囊性病变，因此在影像学检查中类似胰腺囊性肿瘤。具有囊性特征的PDA的组织病理学表现分为肿瘤性和非肿瘤性囊肿。肿瘤性囊性改变包括大导管型囊肿（微囊性外观）、肿瘤性黏液囊肿（大囊性外观）、黏液性癌（黏液性非囊性腺癌）以及通常由肿瘤出血坏死引起的退行性囊性改变。非肿瘤性囊性改变包括导管阻塞引起的潴留性囊肿和肿瘤相关性胰腺炎引起的假性囊肿。根据囊性改变的存在、大小、数量和形态，PDA应与各种类型的囊性肿瘤相鉴别。本文通过图片展示具有囊性特征的PDA的组织病理学分类、相应的横断面成像表现及其鉴别诊断。
