Diederich S, Wernecke K, Löhnert J, Peters P E
Institut für Klinische Radiologie, Westfälische Wilhelms-Universität Münster.
Rofo. 1993 Apr;158(4):325-31. doi: 10.1055/s-2008-1032658.
We analysed sonographic (n = 19) and CT (n = 15) findings in 19 patients with intrapancreatic metastases (solitary: n = 8, multiple: n = 11) from solid tumours. The diagnosis was confirmed either histologically (n = 5) or by the follow-up showing decrease of the size of the lesion due to chemotherapy (n = 3) or progression without specific therapy (n = 11). Clinically or serologically organ-related symptoms were found in 5 cases, whereas the rest of the patients were free of symptoms. Sonographically the metastases appeared hypoechogeneic compared to normal pancreatic parenchyma. In 15 cases CT at the time of sonographic investigation demonstrated hypodense intrapancreatic lesions (8/15) or bulging of the organ contour without differences in density (2/15). In some patients (5/15) sonographically detected metastases measuring less than 2 cm were not discovered via CT. In a patient with known malignancy multiple intrapancreatic lesions must be considered as metastases. Differential diagnosis includes diffusely growing pancreatic carcinoma, haemorrhagic necrotising pancreatitis and focal infiltrates due to malignant lymphoma.
我们分析了19例患有胰腺内实体肿瘤转移灶(单发:8例,多发:11例)患者的超声检查结果(n = 19)和CT检查结果(n = 15)。诊断通过组织学确诊(n = 5),或通过随访证实,即化疗后病变大小减小(n = 3)或未经特殊治疗病情进展(n = 11)。5例患者出现临床或血清学相关器官症状,其余患者无症状。超声检查显示,转移灶相对于正常胰腺实质呈低回声。在15例患者中,超声检查时CT显示胰腺内低密度病变(8/15)或器官轮廓凸起但密度无差异(2/15)。部分患者(5/15)超声检查发现的直径小于2 cm的转移灶,CT未发现。对于已知患有恶性肿瘤的患者,胰腺内多发病变必须考虑为转移灶。鉴别诊断包括弥漫性生长的胰腺癌、出血坏死性胰腺炎和恶性淋巴瘤引起的局灶性浸润。