title: Adenosquamous carcinoma of pancreas: CT and MR imaging features in eight patients, with pathologic correlations and comparison with adenocarcinoma of pancreas.
abstract: OBJECTIVE
  To reveal the CT and MR imaging features of adenosquamous carcinoma of pancreas (ASqC) in eight patients.
  
  
  METHODS
  This study was approved by our institutional review board. Eight patients with ASqC were included in this study. Radiologic and pathologic findings were reviewed in each lesion. Additionally, radiologic imaging findings were compared between ASqC and controlled adenocarcinoma groups.
  
  
  RESULTS
  Significant differences between ASqC and adenocarcinoma groups were noted in lesion shape, enhancement pattern on dynamic CT images, the presence or absence of necrosis, and tumor thrombus in the portal vein (PV) system. Compared with adenocarcinoma, ASqC tended to be round-lobulated shape (100% vs. 57.6%), have necrotic portions (100% vs. 39.4%), and have tumor thrombus in the PV system (37.5% vs. 6.1%). Extensive central necrosis was found in six (75%) of ASqC lesions. More lesions in ASqC group (62.5% vs. 12.1%) showed the highest absolute attenuation on pancreatic arterial phase (PAP) or portal venous phase (PVP) images, although the average attenuation values of all ASqC lesions on PAP, PVP, and delayed phase images were almost the same. Five (83.3%) of six resected lesions appeared as nodular type macroscopically. Microscopically, all lesions did not show infiltrating growth pattern, but showed an intermediate growth pattern, and were surrounded incompletely by fibrous tissue.
  
  
  CONCLUSIONS
  ASqC tended to be a round-lobulated lesion with extensive central necrosis. Additionally, tumor thrombus in the PV system was often present. These CT and MR imaging features could be a useful clue for diagnosing ASqC.
authors.affiliation: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, 920-8641, Japan. fumihitotoshima@gmail.com.
authors.forename: Fumihito
authors.initials: F
authors.lastname: Toshima
authors.affiliation: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.
authors.forename: Dai
authors.initials: D
authors.lastname: Inoue
authors.affiliation: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.
authors.forename: Norihide
authors.initials: N
authors.lastname: Yoneda
authors.affiliation: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Minami
authors.affiliation: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kobayashi
authors.affiliation: Department of Pathology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Ikdeda
authors.affiliation: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsui
authors.affiliation: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Gabata
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: Adenosquamous carcinoma; CT; Invasive ductal adenocarcinoma; MR