title: Is there any clinical or radiologic feature as a preoperative marker for differentiating mass-forming pancreatitis from early-stage pancreatic adenocarcinoma?
abstract: OBJECTIVE
  The differential diagnosis of early-stage pancreatic cancer and mass-forming pancreatitis is still unsettled. The purpose of the present study was to define the differential feature of focal mass-forming pancreatitis and malignant mass using aspects of clinical, laboratory and imaging features on pancreatogram or computed tomography (CT).
  
  
  METHODS
  Between April 1995 and May 2003, 15 patients confirmed as inflammatory mass after surgical resection for pancreatic mass and 21 patients with early-stage pancreatic adenocarcinoma among the patients diagnosed as pancreatic malignancy were included in our study. Hospital records, laboratory results, findings of imaging studies and pathological findings were reviewed retrospectively.
  
  
  RESULTS
  Regarding the clinical characteristics, the history of previous pancreatitis was distinguished in group with mass-forming pancreatitis. Incidence of jaundice was higher in the group with adenocarcinoma than in the mass-forming pancreatitis group. For laboratory results, CA19-9 level and alkaline phosphatase level were significantly elevated in the malignant group. Findings such as hyperattenuation on portal venous phase of CT scans and gradual tapering stricture on pancreatogram were differential diagnostic markers between the two groups. A portion of patients with mass-forming pancreatitis demonstrated the pathologic characteristics of autoimmune pancreatitis.
  
  
  CONCLUSIONS
  Our 9-year experience suggests that imaging findings such as attenuation pattern on the delayed phase of CT scan and tapering pattern of pancreatic ductal stricture on pancreatogram can help to differentiate mass-forming pancreatitis from early-stage pancreatic adenocarcinoma.
authors.affiliation: Department of Medicine, Sungkyunkwan University School of Medicine Seoul, Korea.
authors.forename: Hyuk
authors.initials: H
authors.lastname: Lee
authors.forename: Jong Kyun
authors.initials: JK
authors.lastname: Lee
authors.forename: Seok Seon
authors.initials: SS
authors.lastname: Kang
authors.forename: Dongil
authors.initials: D
authors.lastname: Choi
authors.forename: Kee-Tack
authors.initials: KT
authors.lastname: Jang
authors.forename: Jeong Hwan
authors.initials: JH
authors.lastname: Kim
authors.forename: Kyu Taek
authors.initials: KT
authors.lastname: Lee
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Paik
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Yoo
authors.forename: Jong Chul
authors.initials: JC
authors.lastname: Rhee
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D000368:Aged; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D050500:Pancreatitis, Chronic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012598:Sclerosis; D014057:Tomography, X-Ray Computed