Klein K A, Stephens D H, Welch T J
Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
Radiographics. 1998 Mar-Apr;18(2):369-78. doi: 10.1148/radiographics.18.2.9536484.
Contrast material-enhanced computed tomographic (CT) scans obtained over a 10-year period in 66 patients with metastases to the pancreas were retrospectively reviewed. The primary tumors most commonly responsible for these metastases were renal cell carcinoma (30.3%) and bronchogenic carcinoma (22.7%). Metastases showed no predilection for any particular part of the pancreas. The majority (75.8%) of metastases appeared as tumors with discrete margins, and most of these tumors were round or ovoid with smooth borders. Over three-fourths of the lesions demonstrated enhancement (usually heterogeneous). Vascular involvement was uncommon. In those patients in whom pancreatic metastases were discovered some time after the primary tumor was identified, the interval ranged from 2 to 295 months, with the longest mean interval (120.2 months) being associated with metastatic tumors from renal cell carcinoma. The appearance of these tumors at CT--predominantly hyperattenuating masses, often with nonenhancing internal components--was similar to that of primary renal cell carcinoma. In most pancreatic metastases, however, clinical information in conjunction with CT characteristics such as multiplicity of tumors or hypervascularity permit differentiation of metastases from primary neoplasm. When diagnosis of a pancreatic neoplasm is uncertain, percutaneous biopsy often permits histologic confirmation of the tumor type.
回顾性分析了66例胰腺转移瘤患者在10年期间进行的对比剂增强计算机断层扫描（CT）。导致这些转移瘤的最常见原发肿瘤是肾细胞癌（30.3%）和支气管源性癌（22.7%）。转移瘤在胰腺的任何特定部位均无偏好。大多数转移瘤（75.8%）表现为边界清晰的肿瘤，其中大多数肿瘤呈圆形或椭圆形，边界光滑。超过四分之三的病灶有强化（通常不均匀）。血管受累不常见。在那些在发现原发肿瘤一段时间后才发现胰腺转移瘤的患者中，间隔时间为2至295个月，平均间隔时间最长（120.2个月）的是肾细胞癌转移瘤。这些肿瘤在CT上的表现——主要为高密度肿块，内部常有不强化成分——与原发性肾细胞癌相似。然而，在大多数胰腺转移瘤中，结合临床信息以及肿瘤的多发性或高血供等CT特征，可将转移瘤与原发性肿瘤区分开来。当胰腺肿瘤的诊断不确定时，经皮活检通常可对肿瘤类型进行组织学确诊。
