Austin J Radiol. 2014;1(1): 1.
Rajesh S1*, Gupta Shailesh1 and Bihari Chhagan2
1Department of Radiology, Institute of Liver and Biliary Sciences, India
2Department of Pathology, Institute of Liver and Biliary Sciences, India
*Corresponding author: Rajesh S, Department of Radiology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi-110070, India
Received: September 11, 2014; Accepted: September 15, 2014; Published: September 19, 2014
58 year old male presented with complaints of epigastric discomfort, fatigue and recurrent vomiting since 3 months. Images from the magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS) of the patient are provided (Figure 1).
Figure 1 : Axial (a) and coronal (b) thick slab 3D MRCP images and axial T2 gradient sequence (c) and endoscopic ultrasound image (d) shows a clustered cystic lesion (arrow) having thin wall, in head and neck region of pancreas communicating with a dilated MPD. Associated dilatation of side branches is also seen.
IPMN of the pancreas is a distinct group of cystic low-grade malignant tumors arising from epithelial lining of pancreatic duct. It presents with non-specific symptoms such as epigastric pain, weight loss and diarrhea and can be difficult to differentiate from chronic pancreatitis both clinically and on imaging. Malignant transformation is difficult to assess on imaging, however, enhancing solid mural nodules and main pancreatic duct diameter >10mm are termed as high risk stigmatas and if present are highly suggestive of malignant IPMN, while cyst size >3 cm, thick enhancing cyst wall and non enhancing mural nodules are considered as worrisome features.