title: CT and MRI findings with contrast enhancement of small pancreatic adenocarcinoma in the late phase.
abstract: A 60-year-old female was found to have high serum amylase concentrations at a medical check-up. Dynamic computed tomography and magnetic resonance imaging demonstrated a mass in the body of the pancreas, which was enhanced in the late phase of the scans by administration of a contrast medium. Endoscopic retrograde pancreatography showed a stenosis of the main pancreatic duct at the body, and brushing cytology from the region revealed adenocarcinoma. Distal pancreatectomy was performed. The tumor was a well-differentiated adenocarcinoma, measuring 15 x l0 mm. Fibrous tissues were sparsely distributed in the tumor, and there was an increase of dilated veins, in particular at the margin. Late-phase enhancement of the tumor with computed tomography or magnetic resonance imaging was considered to be correlated with this abundant vascular structure in the tumor. Marked tumor enhancement in the late phase might be a characteristic finding suggesting an early-stage pancreatic adenocarcinoma, which should be carefully checked.
authors.affiliation: Department of Gastroenterology, The Cancer Institute Ariake Hospital, Tokyo, Japan. rizasusu@isis.ocn.ne.jp
authors.forename: Susumu
authors.initials: S
authors.lastname: Hijioka
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ikari
authors.forename: Akira
authors.initials: A
authors.lastname: Kamei
authors.forename: Koichi
authors.initials: K
authors.lastname: Takano
authors.forename: Shingo
authors.initials: S
authors.lastname: Asahara
authors.forename: Naoya
authors.initials: N
authors.lastname: Fujita
authors.forename: Miyuki
authors.initials: M
authors.lastname: Shimizu
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Rikiya
authors.initials: R
authors.lastname: Fujita
authors.forename: Keiko
authors.initials: K
authors.lastname: Sasaki
mesh_terms: D000681:Amylases / Q000097:blood; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D010179:Pancreas / Q000473:pathology; D010180:Pancreatectomy; D010183:Pancreatic Ducts / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D036542:Tomography, Spiral Computed; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D000681:Amylases; D019786:Gadolinium DTPA