Cystic dystrophy of the duodenal wall in the heterotopic pancreas: radiopathological correlations.
OBJECTIVE
The purpose of this work was to correlate the CT features of cystic dystrophy in heterotopic pancreas (CDHP) with pathological features.


METHODS
Patients were selected from 190 patients who underwent pancreatico-duodenectomy over a 10 year period in our institution. CT findings were retrospectively analyzed in 20 cases and correlated with pathological findings.


RESULTS
Lesions were found to be located in the inner part of the second portion of the duodenum in all except one case. In all cases, the duodenal wall was thickened, both at CT and at histopathological examination, and moderate to strong contrast enhancement of the duodenal wall was noted at CT in all cases but one. Cysts were multiple in all cases. No heterotopic pancreas was identified with CT. Inflammatory changes with or without enlarged nodes were detected on CT in 15 of 20 cases. Chronic pancreatitis was present in 10 cases at pathology, including 5 cases with calcifications. The radiopathological correlation was excellent for all criteria but two: the size of the cysts and the extent of pyloric involvement.


CONCLUSIONS
In patients with CDHP, CT features correlate well with pathological results. Multiple cysts located in an enlarged duodenal wall with postcontrast enhancement and inflammatory changes are strongly suggestive of CDHP.
Vullierme
M P
MP
Department of Radiology, Hôpital Beaujon, Clichy, France.
Vilgrain
V
V
Fléjou
J F
JF
Zins
M
M
O'Toole
D
D
Ruszniewski
P
P
Belghiti
J
J
Menu
Y
Y
D000328:Adult; D002828:Choristoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D004378:Duodenal Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging; D016577:Pancreaticoduodenectomy; D014057:Tomography, X-Ray Computed