Imaging findings of pancreatic cystic lesions in von Hippel-Lindau disease.
OBJECTIVE
The aim of this study was to characterize the pancreatic cystic lesions in von Hippel-Lindau (VHL) disease and to document the changes that occur in the pancreas.


METHODS
We retrospectively analyzed the medical records and the computed tomography (CT) and magnetic resonance imaging (MRI) findings of 20 VHL patients who were diagnosed between 1996 and 2010 at our hospital. The clinical findings, family history and type of tumors and/or cysts were reviewed for each patient. We also analyzed the imaging findings for the pancreas in detail.


RESULTS
Pancreatic involvement was noted in 16 of the 20 patients (80%). Eleven patients had multiple cysts diffusely distributed in the pancreas, and one patient had a single cyst in the pancreas head. Two patients had serous cystic neoplasms (SCNs) with multiple cysts, and another two patients had neuroendocrine tumors (NETs) which were conventional radiological findings. The largest cysts of four patients (26.7%) increased in size and that of three patients (20%) decreased in size during the follow-up period. We performed surgical resections for the pancreatic tumors (one NET and one SCN) and also performed endoscopic treatment for a pancreatic cyst in one VHL patient with obstructive jaundice. None of the patients died as a result of pancreatic disease.


CONCLUSIONS
The most common type of pancreatic lesions was multiple cysts. SCNs were present in only 10% of the VHL patients. Pancreatic cysts showed positive and/or negative growth according to the CT and MRI findings. The pancreatic cystic lesions did not influence the outcome of the VHL patients.
Gastroenterology Division, Yokohama City University Graduate School of Medicine, Japan. norikoba@yokohama-cu.ac.jp
Noritoshi
N
Kobayashi
Takamitsu
T
Sato
Shingo
S
Kato
Seitaro
S
Watanabe
Kunihiro
K
Hosono
Takeshi
T
Shimamura
Hiroshi
H
Iida
Hiroki
H
Endo
Tomoko
T
Koide
Hirokazu
H
Takahashi
Masato
M
Yoneda
Wataru
W
Shibata
Yasunobu
Y
Abe
Masahiko
M
Inamori
Hiroyuki
H
Kirikoshi
Satoru
S
Saito
Shin
S
Maeda
Atsushi
A
Nakajima
Kensuke
K
Kubota
D000293:Adolescent; D000328:Adult; D002648:Child; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010181:Pancreatic Cyst / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D006623:von Hippel-Lindau Disease / Q000000981:diagnostic imaging / Q000473:pathology*