By Mirko D'Onofrio
Although curiosity in pancreatic pathology is particularly excessive within the radiological and gastroenterological groups, it really is nonetheless the case that much less is understood approximately pathology of the pancreas than approximately liver pathology, for instance. prognosis will depend on the constitution of the pancreatic lesion, which might be at once visualized on US, CT or MR photos. This atlas, which encompasses either the imaging and the pathology of pancreatic neoplasms, will hence be worthwhile in allowing radiologists and sonographers to appreciate the underlying pathology and in permitting pancreatic pathologists to appreciate the imaging translation.
The emphasis within the atlas is particularly a lot at the pathological and imaging appearances, with lots of the textual content targeted first and foremost of the chapters. A complete review is equipped of usual and abnormal shows and various features of universal and unusual pancreatic neoplasms, together with ductal adenocarcinoma, neuroendocrine neoplasms, intraductal papillary mucinous neoplasms, cystic neoplasms, metastases and lymphoma.
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Extra resources for Imaging and Pathology of Pancreatic Neoplasms: A Pictorial Atlas
16 M. D’Onofrio et al. a b c V A Fig. 7 Ductal adenocarcinoma. (a) IOUS: pancreatic head mass (asterisk) not involving the main vessels. (b) IOUS: pancreatic head hypoechoic mass (asterisk) not separated from the superior mesenteric vein with a small neoplastic portion (arrow) within the lumen of the vein. The wall of the vein appears irregular with deformation of the vessel. (c) IOUS: pancreatic head mass (asterisk) involving the superior mesenteric vein (V) and artery (A) Ductal Adenocarcinoma 17 a b c d e f Fig.
F MRCP shows a markedly dilated biliary tree, with an abrupt cut-off of the common bile duct (C in d) in the head of the pancreas and a dilated Wirsung duct (W in d). At dynamic study (e, f), the lesion appears almost isovascular in comparison to the adjacent pancreatic parenchyma 24 a c Fig. 13 Ductal adenocarcinoma with double-duct sign. (a–d) MRI study: pancreatic head-neck round-shaped mass with blurred margins, typically appearing hypointense (arrow in a) on T1-weighted fat-saturated images and slightly hyperintense (arrow in b) on T2-weighted fat-saturated images.
Common bile duct (C in c) is normal. The mass infiltrates the superior mesenteric vein (V in d) and is very close to the superior mesenteric artery (A in d). (e) Surgical specimen (pancreaticoduodenectomy): ductal adenocarcinoma (asterisk) involving the Wirsung duct (W). The common bile duct (C) is normal. The pancreatic surface of the vascular bed is involved (arrow). (f–j) Superimposed drawings better clarify the lesion (brown circle), the Wirsung duct (yellow line), and the common bile duct (green line) in the imaging and surgical specimen.