title: Macrocystic neoplasms of the pancreas: CT differentiation of serous oligocystic adenoma from mucinous cystadenoma and intraductal papillary mucinous tumor.
abstract: OBJECTIVE
  The purpose of our study was to determine useful CT criteria for differentiating serous oligocystic adenomas of the pancreas from other similarly presenting neoplasms, such as mucinous cystadenoma and intraductal papillary mucinous tumor of the branch duct type.
  
  
  METHODS
  Forty-one patients with histologically confirmed macrocystic neoplasms of the pancreas were enrolled: serous oligocystic adenoma in 10 patients, mucinous cystadenoma in 13, and intraductal papillary mucinous tumor in 18. Location, greatest dimension, shape, presence of mural nodules, presence of wall calcification, and the extent and degree of main pancreatic duct (MPD) dilatation were analyzed with CT. The lesions were categorized into seven groups according to their shapes: multicystic, lobulated contour with and without internal septation, smooth contour with and without internal septation, pleomorphic cystic, and clubbed fingerlike cystic. Comparative studies were performed using Fisher's exact test and the Mann-Whitney U test.
  
  
  RESULTS
  Significant differences in lesion shape were found between serous oligocystic adenoma and the other macrocystic neoplasms (mucinous cystadenoma [p < 0.05], intraductal papillary mucinous tumor [p < 0.05]). Serous oligocystic adenoma had a multicystic or lobulated contour with or without septation, whereas mucinous cystadenoma had a smooth contour with or without septation and intraductal papillary mucinous tumor had either a pleomorphic or a clubbed fingerlike cystic shape. Serous oligocystic adenoma showed proximal MPD dilatation from the lesion, whereas intraductal papillary mucinous tumor showed distal or whole MPD dilatation (p < 0.05). No significant difference was apparent among the three diseases in terms of location, greatest dimension, or presence of calcification or mural nodules.
  
  
  CONCLUSIONS
  Serous oligocystic adenoma of the pancreas has characteristic CT findings that differentiate it from other cystic tumors. It appears as a multicystic or lobulated cystic lesion with septation.
authors.affiliation: Department of Radiology and Institute of Radiation Medicine, Seoul National University Hospital and College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea.
authors.forename: Sang Youn
authors.initials: SY
authors.lastname: Kim
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Se Hyung
authors.initials: SH
authors.lastname: Kim
authors.forename: Kyung-Sook
authors.initials: KS
authors.lastname: Shin
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Kim
authors.forename: Su Kyung
authors.initials: SK
authors.lastname: An
authors.forename: Chang Jin
authors.initials: CJ
authors.lastname: Han
authors.forename: Joon Koo
authors.initials: JK
authors.lastname: Han
authors.forename: Byung Ihn
authors.initials: BI
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging* / Q000473:pathology; D018291:Cystadenoma, Mucinous / Q000000981:diagnostic imaging* / Q000473:pathology; D018293:Cystadenoma, Serous / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed