Abstract
Purpose
This study was undertaken to analyse the clinical characteristics and computed tomography (CT) imaging features of patients with pancreatic acinar cell carcinoma and to clarify characteristic imaging features.
Materials and methods
Clinical and CT imaging records of ten patients with pancreatic acinar cell carcinoma (three women and seven men; mean age, 58 years) examined using multidetector CT scanners were retrospectively studied. CT features emphasised included lesion location, size, shape, margin, solid or cystic component, density and enhancement. Imaging results were correlated with intraoperative surgical and pathological results.
Results
Lesions were distributed throughout the pancreatic head (n=3), body (n=3), tail (n=2) and both body and tail (n=2). The average diameter was 6.1 cm, varying from 2.3 cm to 15.8 cm. The tumours were round or oval (n=7) or lobular (n=3). Seven tumours appeared as enhanced solid pancreatic masses, with the large masses having hypodense areas; three had >75 % cystic component; seven (70%), including four solid and three cystic masses, had wellcircumscribed or partially well-defined thin, enhanced encapsulation. After contrast injection, the masses presented heterogeneous enhancement.
Conclusions
Acinar cell carcinoma should always be considered when a large pancreatic mass with typical imaging is found in solid masses with variably sized central cystic areas or cystic masses.
Riassunto
Obiettivo
Lo scopo di questo studio è stato quello di analizzare le caratteristiche cliniche e di imaging TC dei pazienti con carcinoma a cellule acinari del pancreas e di chiarire le caratteristiche imaging del carcinoma a cellule acinari.
Materiali e metodi
Sono stati retrospettivamente esaminate gli aspetti clinici e di imaging TC di 10 pazienti con diagnosi di carcinoma a cellule acinari del pancreas (tre femmine e sette maschi, età media 58 anni) sottoposti ad esame TC multidetettore. Le caratteristiche TC analizzate hanno incluso sede, dimensione, forma, margini, componente solida o cistica, densità ed enhancement delle lesioni. Gli aspetti dell’ imaging sono stati quindi correlati con i risultati intraoperatori chirurgici e patologici.
Risultati
La sede delle lesioni è risultata ubiquitaria a livello di testa (n=3), corpo (n=3), coda (n=2), e sia di corpo che coda (n=2) del pancreas. Il diametro medio della lesione è risultato pari a 6,1 cm, compreso tra 2,3 cm e 15,8 m. I tumori sono risultati di forma rotonda o ovale (n=7) o lobulare (n=3). Sette tumori sono risultate lesioni solide del pancreas, con aree ipodense contestuali; tre presentavano componenti cistica superiore al 75%; sette tumori (70%), di cui quattro solidi e tre con componente cistica, presentavano pareti sottili ben circoscritte o pazialmente sottile, vascolarizzata. Dopo iniezione di mezzo di contrasto, l’enhancement risultava eterogeneo.
Conclusioni
La diagnosi di carcinoma a cellule acinari dovrebbe essere presa in considerazione nel caso di lesioni pancreatiche solide di grandi dimensioni con caratteristiche imaging tipiche e presenza di aree centrali cistiche di dimensioni variabili.
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Hu, S., Hu, S., Wang, M. et al. Clinical and CT imaging features of pancreatic acinar cell carcinoma. Radiol med 118, 723–731 (2013). https://doi.org/10.1007/s11547-012-0908-5
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DOI: https://doi.org/10.1007/s11547-012-0908-5