title: Solid pseudopapillary neoplasm of the pancreas: CT imaging features and radiologic-pathologic correlation.
abstract: OBJECTIVE
  We aimed to evaluate the imaging features of solid pseudopapillary neoplasm (SPN) of the pancreas with an emphasis on radiologic-pathologic correlation.
  
  
  METHODS
  Ten patients (all female; mean age, 32 years) with histologic or cytologic diagnosis of SPN encountered between January 2007 and December 2013 were included in this study. Preoperative computed tomography (CT) images were reviewed for location, attenuation, enhancement pattern, margin, shape, size, morphology, presence of capsule and calcification. CT appearances were correlated with histopathologic findings.
  
  
  RESULTS
  Tumors in the distal pancreatic body and tail had a tendency to be larger (mean size 12.6 cm vs. 4.0 cm). Six of the nine tumors that were resected had a fibrous pseudocapsule at histology, five of which could be identified on CT scan. Eight lesions had mixed hypoenhancing solid components and cystic areas corresponding to tumor necrosis and hemorrhage. The two smallest lesions were purely solid and nonencapsulated. Varied patterns of calcification were seen in four tumors. Three of the four pancreatic tail tumors invaded the spleen. At a median follow-up of 53 months, there was no evidence of recurrence in the nine patients who underwent surgical resection of the tumor.
  
  
  CONCLUSIONS
  A mixed solid and cystic pancreatic mass in a young woman is suggestive of SPN. However, smaller lesions may be completely solid. Splenic invasion can occur in pancreatic tail SPNs; however, in this series it did not adversely affect the long-term outcome.
authors.affiliation: Department of Diagnostic Imaging, National University Hospital, Singapore; Department of Diagnostic Radiology, National University of Singapore Yong Loo Lin School of Medicine, Singapore. ivyanil10@gmail.com.
authors.forename: Gopinathan
authors.initials: G
authors.lastname: Anil
authors.forename: Junwei
authors.initials: J
authors.lastname: Zhang
authors.forename: Nawal Ebrahim
authors.initials: NE
authors.lastname: Al Hamar
authors.forename: Min En
authors.initials: ME
authors.lastname: Nga
mesh_terms: D000293:Adolescent; D000328:Adult; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D012189:Retrospective Studies; D013154:Spleen / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D047368:Tumor Burden