2024
Magnetic Resonance Imaging: Solid Pseudopapillary Neoplasm of the Pancreas, Mimics and Histopathological Correlation1Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
Synopsis
SPN is a rare epithelial neoplasm of low grade malignant potential for local and metastatic spread, occurring predominantly in young females. Differential diagnosis of SPN includes a wide spectrum of cystic and solid entities in the pancreas including pancreatic neuroendocrine, serous or mucinous cystadenoma or carcinoma, intrapancreatic splenules etc. Contrast enhanced MRI plays a key role in characterization of SPN and its mimics , helps to reach a specific diagnosis and narrows the differential, which is complimentary to EUS and biopsy when findings are equivocal to reach an accurate diagnosis which is of utmost importance for management and treatment planning
Learning Goals:
1. To review contrast enhanced MR imaging features of large and small solid pseudopapillary tumors of the pancreas (SPN)
2. To discuss common mimics of SPN and review imaging characteristics helpful in narrowing the differential with histopathological correlation
3. To discuss appropriate utilization of EUS and biopsy for tissue diagnosis
Background information and content:
The purpose of this presentation is to describe MRI characteristics of solid pseudopapillary Neoplasms of the pancreas (SPN), differential diagnosis of common mimics on MR imaging with histopathological correlation. SPN is a rare epithelial neoplasm and considered a low grade malignant tumor with low potential for local and metastatic spread, occurring predominantly in young females. Differential diagnosis of SPN includes a wide spectrum of cystic and solid entities in the pancreas including pancreatic neuroendocrine tumors, serous or mucinous cystadenoma or carcinoma, intrapancreatic splenules, inflammatory mass etc. Contrast enhanced MRI is a noninvasive method and because of its superior soft tissue contrast and multiplanar capabilities is helpful in narrowing the differential diagnosis and is complimentary to endoscopic ultrasound (EUS) with biopsy for equivocal cases.Key Anatomic, Pathophysiologic Issues, Imaging Findings and Imaging Technique:
Generally SPN is usually a large solitary well-demarcated solid and/or cystic tumor that may be encapsulated and occurs anywhere, typically in the tail or head of the pancreas. Small SPN are usually solid and lack typical features of cystic change and hemorrhagic degeneration. MR imaging features such as identifying the capsule, solid-cystic components and hemorrhagic areas to avoid misdiagnosis will be discussed along with its mimics. MRI protocol and advantages over other modalities will be discussed in addition to treatment planning and management.Conclusion:
Contrast enhanced MRI plays a key role in characterization of SPN and its mimics. MRI helps to reach a specific diagnosis and narrow the differential diagnosis, which is complimentary to EUS and biopsy when findings are equivocal to reach an accurate diagnosis which is of utmost importance for management and treatment planning.Acknowledgements
No acknowledgement found.References
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