대낭성 및 단방성 변종을 보인 췌장의 장액성 낭선종의 방사선학적 소견 : 병리 소견과의 비교

Abstract

Purpose : To evaluate the radiologic findings of the serous cystadenomas of the pancreas with macrocystic or unilocular variants and to compare them with the pathologic findings. Materials and Methods : In eight patients (7 females and 1 male ranging in age from 26 to 49 [mean, 37] years) with surgically proven serous cystadenomas, the findings of abdominal CT(n=8), abdominal songography(US, n=8), endoscopic retrograde pancreatography(ERCP, n=6), endoscopic sonography(EUS, n=3), and MRI(n=1) were evaluated. The location and size of tumors, lobulation, internal septa, solid component, calcification. communication with the pancreatic duct, dilatation of the proximal pancreatic duct, and contrast enhancement on CT were assessed and compared with the pathologic findings. Results : Tumors were located in the head(n=3), body(n=3) and tail (n=2), and their mean size was 4 (range, 1-8)cm. Abdominal CT scanning revealed well-defined cystic masses composed of macrocyst(s) with calcification (n=3) and dilatation of the proximal duct (n=2). Three cases showed contrast enhancement of the cystic walls, the pathologic examination of which revealed fibrotic tissues .Four tumeurs were unilocular without septation or lobulation; these features, together with calcification, were depicted more clearly by US and EUS. ERCP revealed no communication between the cysts and pancreatic ducts. Imaging studies showed that macrocystic adenomas were superimposed on mucinous cystadenomas, and unilocular adenomas were indistinguishable from pseudocysts. Conclusion : Serous cystadenomas of the pancreas with macrocystic or unilocular variants are common in middle-aged women. Features present due to the existence of fibrotic tissues, and which may be reveled by contrast-enhanced CT, include internal septa, calcification, duct dilation, and prominent enhancement of the cystic wall. Serous cystadenoma should be included in the differential diagnosis of macrocystic or unilocular cystic lesions of the pancreas.