Hara Ayaka, Yamada Yasunari, Fukuzawa Kengo, Motomura Mitsuteru, Kuboyama Yusuke, Sakata Kazuhito, Takaji Ryo, Asayama Yoshiki, Takaki Hajime
Department of Radiology, Oita Red Cross Hospital, Chiyo-machi, Oita, Japan.
Department of Surgery, Oita Red Cross Hospital, Chiyo-machi, Oita, Japan.
Radiol Case Rep. 2022 Jul 7;17(9):3439-3445. doi: 10.1016/j.radcr.2022.06.047. eCollection 2022 Sep.
Large-duct type pancreatic ductal adenocarcinoma (PDA) is a rare morphologic variant forming large duct elements. This case report, to our knowledge, is the first report of a large-duct type PDA with a "honeycomb" appearance resembling a serous cystic neoplasm (SCN) on CT and MRI. The patient is an 82-year-old woman who presented with upper abdominal pain. Dynamic contrast-enhanced CT revealed a multilocular cyst with honeycomb loculi, in which the cyst walls showed gradual enhancement. On T2-weighted MRI, the mass displayed inhomogeneous hyperintensity characterized by a honeycomb appearance with irregular and thick hypointense cyst walls. The patient underwent distal pancreatectomy; histopathological diagnosis was large-duct type PDA. Although the imaging features of large-duct type PDA may resemble those of SCN, this distinction between PDA and SCN is important because the treatment options are very different.
大导管型胰腺导管腺癌（PDA）是一种形成大导管成分的罕见形态学变异。据我们所知，本病例报告是首例在CT和MRI上表现为类似浆液性囊性肿瘤（SCN）的“蜂窝状”外观的大导管型PDA。患者为一名82岁女性，表现为上腹部疼痛。动态对比增强CT显示一个多房性囊肿，内有蜂窝状小腔，囊肿壁呈渐进性强化。在T2加权MRI上，肿块表现为不均匀高信号，呈蜂窝状外观，囊肿壁不规则且增厚，呈低信号。患者接受了胰体尾切除术；组织病理学诊断为大导管型PDA。尽管大导管型PDA的影像学特征可能与SCN相似，但区分PDA和SCN很重要，因为治疗方案差异很大。
