title: Imaging studies of intraductal tubulopapillary neoplasms of the pancreas: 2-tone duct sign and cork-of-wine-bottle sign as indicators of intraductal tumor growth.
abstract: OBJECTIVE
  The objective of this study was to describe the imaging findings for intraductal tubulopapillary neoplasms of the pancreas.
  
  
  METHODS
  Eleven pancreatic tumors pathologically confirmed as intraductal tubulopapillary neoplasm were retrospectively collected. The dynamic contrast-enhanced computed tomography (CT), magnetic resonance (MR) imaging including MR cholangiopancreatography (MRCP), ultrasound, and endoscopic retrograde cholangiopancreatography (ERCP) results were reviewed. The 2-tone duct sign and cork-of-wine-bottle sign were reviewed as indicators of intraductal tumor growth on CT/MR and MRCP/ERCP images, respectively.
  
  
  RESULTS
  A 2-tone duct sign was noted on the dynamic CT images (7/10, 70%) and on the MR imaging (5/8, 63%). The distal main pancreatic duct was dilated in all the patients except one, who had a branch duct lesion. A cork-of-wine-bottle sign was observed on the MRCP image (3/8, 38%) and on the ERCP image (3/6, 50%).
  
  
  CONCLUSIONS
  Intraductal tubulopapillary neoplasms are rare tumors showing characteristic imaging findings such as the 2-tone duct sign and the cork-of-wine-bottle sign that represent their intraductal growth.
authors.affiliation: Department of Pathology, Saitama Medical University, International Medical Center, Hidaka, Japan. utaroh-motosugi@nifty.com
authors.forename: Utaroh
authors.initials: U
authors.lastname: Motosugi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: Toru
authors.initials: T
authors.lastname: Furukawa
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Hatori
authors.forename: Izumi
authors.initials: I
authors.lastname: Fujita
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Fuyuhiko
authors.initials: F
authors.lastname: Motoi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kanno
authors.forename: Tomoo
authors.initials: T
authors.lastname: Watanabe
authors.forename: Naoto
authors.initials: N
authors.lastname: Koike
authors.forename: Isamu
authors.initials: I
authors.lastname: Koyama
authors.forename: Junya
authors.initials: J
authors.lastname: Kobayashi
authors.forename: Michio
authors.initials: M
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media