Cystic dystrophy of the duodenal wall in the heterotopic pancreas: Radiopathological correlations

Purpose: The purpose of this work was to correlate the CT features of cysti c dystrophy in heterotopic pancreas (CDHP) with pathological features. Methods: Patients were selected from 190 patients who underwent pancreatico duodenectomy over a 10 year period in our institution. CT findings were ret rospectively analyzed in 20 cases and correlated with pathological findings . Results: Lesions were found to be located in the inner part of the second p ortion of the duodenum in all except one case. In all cases, the duodenal w all was thickened, both at CT and at histopathological examination, and mod erate to strong contrast enhancement of the duodenal wall was noted at CT i n all cases but one. Cysts were multiple in all cases. No heterotopic pancr eas was identified with CT. Inflammatory changes with or without enlarged n odes were detected on CT in 15 of 20 cases. Chronic pancreatitis was presen t in 10 cases at pathology, including 5 cases with calcifications. The radi opathological correlation was excellent for all criteria but two: the size of the cysts and the extent of pyloric involvement. Conclusion: In patients with CDHP, CT features correlate well with patholog ical results. Multiple cysts located in an enlarged duodenal wall with post contrast enhancement and inflammatory changes are strongly suggestive of CD HP.