Intraductal papillary tumors of the pancreas - Histopathologic correlationof MR cholangiopancreatography findings

Purpose: To evaluate MR cholangiopancreatography (MRCP) findings of intradu ctal papillary tumors of the pancreas and correlate them with histopatholog y. Material and Methods. Seventeen patients with intraductal papillary tumor o f the pancreas underwent MRCP before surgery. MRCP findings were correlated to histopathology with regard to the presence of septa and excrescent nodu les in the cystic lesion, communication between the cystic lesion and the m ain pancreatic duct (MPD), degree of dilatation of MPD, and dilatation of t he common bile duct (CBD). Results: MRCP demonstrated septa in 17 cases (100%), excrescent nodules in 8 cases (47.1%), communication between the intraductal papillary tumor and the MPD in 14 cases (82.3%), dilatation of MPD over 50% in 6 cases (35.3%), and dilatation of CBD in 3 cases (17.6%). These findings showed excellent correlation with histopathology. The septum on MRCP corresponded with a lay er of connective tissue with pancreatic duct epithelium. Excrescent nodules in the carcinomas consisted not only of malignant cells, but also of dyspl asia and adenoma. Excrescent nodules in adenomas were consistent not only w ith minimal papillary growth of adenoma, but also with proliferation of fib rosis, and hematoma and organized fibrin with minimal fibrosis. Pancreatic tissue was affected by chronic pancreatitis in all cases. Cases with dilata tion of CBD on MRCP were due to microscopic invasion by the carcinoma. Conclusion. MRCP appearances of intraductal papillary tumors are well corre lated with the findings at histopathology.