THE ROLE OF ULTRASOUND IN THE DIFFERENTIAL-DIAGNOSIS OF SEROUS AND MUCINOUS CYSTIC TUMORS OF THE PANCREAS

Objective: To evaluate the usefulness of a series of ultrasound parame ters in the differential diagnosis between serous and mucinous forms o f cystic tumours of the pancreas. Setting: Retrospective comparative s tudy between the histological analysis of surgical specimens from cyst ic tumours of the pancreas (4 serous cystadenomas, 6 mucinous cystaden omas and 11 mucinous cystadenocarcinomas) and ultrasound evaluation. M ethods: The ultrasound images of the 21 tumours were analysed by an op erator who did not know the result of the histological diagnosis and w ere divided according to Johnson's criteria (number of cysts > 6 and d iameter < 2 cm for serous tumours; number of cysts < 6 and diameter > 2 cm for mucinous tumours) and according to other anatomicopathologica l parameters such as the presence of septae, endocystic projections, c entral scar, central calcification and/or in the tumour wall. Results: The ultrasound study gave a correct diagnosis in two out of the four (50%) serous cystic tumours. A central scar and internal calcification was present in one of them. Fifteen (88.2%) of the 17 mucinous tumour s were correctly diagnosed; one presented peripheral calcifications an d three endocystic projections. Conclusion: Ultrasound has a high degr ee of sensitivity in the differential diagnosis of serous and mucinous cystic tumours of the pancreas if the ultrasound aspects correspondin g to the anatomicopathological structure of the neoplasms are correctl y evaluated.