Macrocystic neoplasms of the pancreas: CT differentiation of serous oligocystic adenoma from mucinous cystadenoma and intraductal papillary mucinous tumor.
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.
Kim
Sang Youn
SY
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.
Lee
Jeong Min
JM
Kim
Se Hyung
SH
Shin
Kyung-Sook
KS
Kim
Young Jun
YJ
An
Su Kyung
SK
Han
Chang Jin
CJ
Han
Joon Koo
JK
Choi
Byung Ihn
BI
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