SOLID AND PAPILLARY EPITHELIAL NEOPLASM OF THE PANCREAS - IMAGING-PATHOLOGICAL CORRELATION IN 56 CASES

PURPOSE: To evaluate the clinical, pathologic, and imaging findings of solid and papillary epithelial neoplasm (SPEN) of the pancreas and to correlate imaging and gross pathologic features. MATERIALS AND METHOD S: A retrospective review was performed in 56 patients (53 female and three male patients aged 10-74 years [mean age at diagnosis, 25 years] ) with pathologically proved SPEN of the pancreas. All patients underw ent computed tomography (n = 49), ultrasonography (n = 31), or magneti c resonance (MR) imaging (n = 9). Tumor size, location, and imaging fe atures were evaluated and correlated with gross pathologic and histolo gic features. RESULTS: Mean transverse diameter of these tumors was 9. 0 cm (range, 2.5-17.0 cm). They were localized to the tail (n = 30), h ead (n = 18), and body (n = 8) of the pancreas. All tumors contained s ome degree of internal hemorrhage or cystic degeneration, and all were well encapsulated. Areas of hemorrhagic degeneration ranged from soli d friable tumor to gelatinous or cystic cavities and therefore demonst rated variable imaging features. Calcification was noted in 16 patient s. Fluid-debris levels were noted in 10 patients. CONCLUSION: Imaging studies of SPEN of the pancreas consistently demonstrate variable degr ees of hemorrhagic degeneration. Calcification is common. Characterist ic fluid-debris levels and signal intensities seen with MR imaging ind icate blood products. In the appropriate clinical setting, these findi ngs are useful in making a prospective diagnosis.