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Pearls and pitfalls of imaging features of pancreatic cystic lesions: a case-based approach with imaging–pathologic correlation

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Abstract

A variety of neoplastic and non-neoplastic lesions of the pancreas can present with a predominantly cystic architecture. These lesions are increasingly being detected as incidental findings on routine cross-sectional imaging following technological advances in these techniques and their widespread use. The different histopathological behaviors show various common and uncommon imaging findings, and some cases show similar appearance in spite of different histopathology. Each lesion requires specific management because of the differing risk of progression to malignancy, and an accurate imaging diagnosis is crucial. The typical imaging characteristics that differentiate pancreatic cystic lesions have been well described and fully summarized. However, in addition to a small percentage of cases that shows uncommon imaging findings, a substantial percentage of cystic lesions shows overlap** imaging findings that can lead to radiological misdiagnosis. For appropriate diagnosis and optimal treatment strategy, it is important to know the uncommon and overlap** imaging findings of these lesions, in addition to familiarity with the typical aspects. In this article, we reconfirm the well-known characteristic imaging features of pancreatic cystic lesions and present several diagnostically challenging cases, focusing on the uncommon and overlap** imaging findings.

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References

  1. Spinelli KS, Fromwiller TE, Daniel RA, Kiely JM, Nakeeb A, Komorowski RA, et al. Cystic pancreatic neoplasms: observe or operate. Ann Surg. 2004;239:651–7 (discussion 57–9).

    Article  PubMed  PubMed Central  Google Scholar 

  2. Laffan TA, Horton KM, Klein AP, Berlanstein B, Siegelman SS, Kawamoto S, et al. Prevalence of unsuspected pancreatic cysts on mdct. AJR Am J Roentgenol. 2008;191:802–7.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Lee HJ, Kim MJ, Choi JY, Hong HS, Kim KA. Relative accuracy of ct and mri in the differentiation of benign from malignant pancreatic cystic lesions. Clin Radiol. 2011;66:315–21.

    Article  PubMed  Google Scholar 

  4. Ferrone CR, Correa-Gallego C, Warshaw AL, Brugge WR, Forcione DG, Thayer SP, et al. Current trends in pancreatic cystic neoplasms. Arch Surg (Chicago, Ill: 1960). 2009;144:448–54.

    Article  Google Scholar 

  5. Correa-Gallego C, Ferrone CR, Thayer SP, Wargo JA, Warshaw AL, Fernández-Del CC. Incidental pancreatic cysts: do we really know what we are watching? Pancreatology. 2010;10:144–50.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Javadi S, Menias CO, Korivi BR, Shaaban AM, Patnana M, Alhalabi K, et al. Pancreatic calcifications and calcified pancreatic masses: pattern recognition approach on ct. AJR Am J Roentgenol. 2017;209:77–87.

    Article  PubMed  Google Scholar 

  7. Kalb B, Sarmiento JM, Kooby DA, Adsay NV, Martin DR. Mr imaging of cystic lesions of the pancreas. Radiographics. 2009;29:1749–65.

    Article  PubMed  Google Scholar 

  8. Sahani DV, Kadavigere R, Saokar A, Fernandez-del CC, Brugge WR, Hahn PF. Cystic pancreatic lesions: a simple imaging-based classification system for guiding management. Radiographics. 2005;25:1471–84.

    Article  PubMed  Google Scholar 

  9. Sahani DV, Kambadakone A, Macari M, Takahashi N, Chari S, Fernandez-del CC. Diagnosis and management of cystic pancreatic lesions. AJR Am J Roentgenol. 2013;200:343–54.

    Article  PubMed  Google Scholar 

  10. Barral M, Soyer P, Dohan A, Laurent V, Hoeffel C, Fishman EK, et al. Magnetic resonance imaging of cystic pancreatic lesions in adults: An update in current diagnostic features and management. Abdom Imaging. 2014;39:48–65.

    Article  PubMed  Google Scholar 

  11. Palmucci S, Cappello G, Trombatore C, Tilocca C, Todaro R, Mauro LA, et al. Cystic pancreatic neoplasms: diagnosis and management emphasizing their imaging features. Eur Rev Med Pharm Sci. 2014;18:1259–68.

    CAS  Google Scholar 

  12. D'Onofrio M, De Robertis R, Capelli P, Tinazzi Martini P, Crosara S, Gobbo S, et al. Uncommon presentations of common pancreatic neoplasms: a pictorial essay. Abdom Imaging. 2015;40:1629–44.

    Article  PubMed  Google Scholar 

  13. Bollen TL, Wessels FJ. Radiological workup of cystic neoplasms of the pancreas. Visceral Med. 2018;34:182–90.

    Article  Google Scholar 

  14. Sahani DV, Lin DJ, Venkatesan AM, Sainani N, Mino-Kenudson M, Brugge WR, et al. Multidisciplinary approach to diagnosis and management of intraductal papillary mucinous neoplasms of the pancreas. Clin Gastroenterol Hepatol. 2009;7:259–69.

    Article  PubMed  Google Scholar 

  15. Sakorafas GH, Smyrniotis V, Reid-Lombardo KM, Sarr MG. Primary pancreatic cystic neoplasms revisited. Part iii. Intraductal papillary mucinous neoplasms. Surg Oncol. 2011;20:e109–e118118.

    Article  PubMed  Google Scholar 

  16. Tanaka M, Fernández-del Castillo C, Adsay V, Chari S, Falconi M, Jang JY, et al. International consensus guidelines 2012 for the management of ipmn and mcn of the pancreas. Pancreatology. 2012;12:183–97.

    Article  PubMed  Google Scholar 

  17. Mino-Kenudson M, Fernández-del Castillo C, Baba Y, Valsangkar NP, Liss AS, Hsu M, et al. Prognosis of invasive intraductal papillary mucinous neoplasm depends on histological and precursor epithelial subtypes. Gut. 2011;60:1712–20.

    Article  PubMed  Google Scholar 

  18. Klöppel G. Pseudocysts and other non-neoplastic cysts of the pancreas. Semin Diagn Pathol. 2000;17:7–15.

    PubMed  Google Scholar 

  19. Curry CA, Eng J, Horton KM, Urban B, Siegelman S, Kuszyk BS, et al. Ct of primary cystic pancreatic neoplasms: can ct be used for patient triage and treatment? AJR Am J Roentgenol. 2000;175:99–103.

    Article  CAS  PubMed  Google Scholar 

  20. Kosmahl M, Pauser U, Peters K, Sipos B, Lüttges J, Kremer B, et al. Cystic neoplasms of the pancreas and tumor-like lesions with cystic features: A review of 418 cases and a classification proposal. Virchows Arch. 2004;445:168–78.

    Article  CAS  PubMed  Google Scholar 

  21. Fernández-del Castillo C, Warshaw AL. Cystic tumors of the pancreas. Surg Clin N Am. 1995;75:1001–166.

    Article  PubMed  Google Scholar 

  22. Sakorafas GH, Smyrniotis V, Reid-Lombardo KM, Sarr MG. Primary pancreatic cystic neoplasms of the pancreas revisited. Part iv: rare cystic neoplasms. Surg Oncol. 2012;21:153–63.

    Article  PubMed  Google Scholar 

  23. Lawrence B, Gustafsson BI, Chan A, Svejda B, Kidd M, Modlin IM. The epidemiology of gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin N Am. 2011;40(1–18):vii.

    Google Scholar 

  24. Lewis RB, Lattin GE Jr, Paal E. Pancreatic endocrine tumors: radiologic-clinicopathologic correlation. Radiographics. 2010;30:1445–644.

    Article  PubMed  Google Scholar 

  25. Hu S, Zhu L, Song Q, Chen K. Epidermoid cyst in intrapancreatic accessory spleen: computed tomography findings and clinical manifestation. Abdom Imaging. 2012;37:828–33.

    Article  PubMed  Google Scholar 

  26. Kanazawa H, Kamiya J, Nagino M, Uesaka K, Yuasa N, Oda K, et al. Epidermoid cyst in an intrapancreatic accessory spleen: a case report. J Hepato Biliary Pancreatic Surg. 2004;11:61–3.

    Article  Google Scholar 

  27. Sakorafas GH, Smyrniotis V, Reid-Lombardo KM, Sarr MG. Primary pancreatic cystic neoplasms revisited: Part ii. Mucinous cystic neoplasms. Surg Oncol. 2011;20:e93–101.

    Article  PubMed  Google Scholar 

  28. Ventriglia A, Manfredi R, Mehrabi S, Boninsegna E, Negrelli R, Pedrinolla B, et al. Mri features of solid pseudopapillary neoplasm of the pancreas. Abdom Imaging. 2014;39:1213–20.

    Article  PubMed  Google Scholar 

  29. Sakorafas GH, Smyrniotis V, Reid-Lombardo KM, Sarr MG. Primary pancreatic cystic neoplasms revisited. Part i: serous cystic neoplasms. Surg Oncol. 2011;20:e84–92.

    Article  PubMed  Google Scholar 

  30. Levink I, Bruno MJ, Cahen DL. Management of intraductal papillary mucinous neoplasms: Controversies in guidelines and future perspectives. Curr Treat Opt Gastroenterol. 2018;16:316–32.

    Article  Google Scholar 

  31. Nagai K, Doi R, Kida A, Kami K, Kawaguchi Y, Ito T, et al. Intraductal papillary mucinous neoplasms of the pancreas: clinicopathologic characteristics and long-term follow-up after resection. World J Surg. 2008;32:271–8 (discussion 79–80).

    Article  PubMed  Google Scholar 

  32. Schmidt CM, White PB, Waters JA, Yiannoutsos CT, Cummings OW, Baker M, et al. Intraductal papillary mucinous neoplasms: predictors of malignant and invasive pathology. Ann Surg. 2007;246:644–51 (discussion 51–4).

    Article  PubMed  Google Scholar 

  33. Ridtitid W, DeWitt JM, Schmidt CM, Roch A, Stuart JS, Sherman S, et al. Management of branch-duct intraductal papillary mucinous neoplasms: a large single-center study to assess predictors of malignancy and long-term outcomes. Gastrointest Endosc. 2016;84:436–45.

    Article  PubMed  Google Scholar 

  34. Marchegiani G, Andrianello S, Perri G, Pollini T, Caravati A, Secchettin E, et al. The role of age in pancreatic intraductal papillary mucinous neoplasms of the pancreas: same risk of death but different implications for management. Dig Liver Dis. 2018;50:1327–33.

    Article  PubMed  Google Scholar 

  35. Ilic M, Ilic I. Epidemiology of pancreatic cancer. World J Gastroenterol. 2016;22:9694–705.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Habashi S, Draganov PV. Pancreatic pseudocyst. World J Gastroenterol. 2009;15:38–47.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Crippa S, Salvia R, Warshaw AL, Domínguez I, Bassi C, Falconi M, et al. Mucinous cystic neoplasm of the pancreas is not an aggressive entity: lessons from 163 resected patients. Ann Surg. 2008;247:571–9.

    Article  PubMed  Google Scholar 

  38. Salvia R, Crippa S, Falconi M, Bassi C, Guarise A, Scarpa A, et al. Branch-duct intraductal papillary mucinous neoplasms of the pancreas: to operate or not to operate? Gut. 2007;56:1086–90.

    Article  PubMed  Google Scholar 

  39. Hata T, Sakata N, Okada T, Aoki T, Motoi F, Katayose Y, et al. Dilated papilla with mucin extrusion is a potential predictor of acute pancreatitis associated with intraductal papillary mucinous neoplasms of pancreas. Pancreatology. 2013;13:615–20.

    Article  CAS  PubMed  Google Scholar 

  40. Jang JW, Kim MH, Jeong SU, Kim J, Park DH, Lee SS, et al. Clinical characteristics of intraductal papillary mucinous neoplasm manifesting as acute pancreatitis or acute recurrent pancreatitis. J Gastroenterol Hepatol. 2013;28:731–8.

    Article  PubMed  Google Scholar 

  41. Pelletier AL, Hammel P, Rebours V, Couvelard A, Vullierme MP, Maire F, et al. Acute pancreatitis in patients operated on for intraductal papillary mucinous neoplasms of the pancreas: frequency, severity, and clinicopathologic correlations. Pancreas. 2010;39:658–61.

    Article  PubMed  Google Scholar 

  42. Ringold DA, Shroff P, Sikka SK, Ylagan L, Jonnalagadda S, Early DS, et al. Pancreatitis is frequent among patients with side-branch intraductal papillary mucinous neoplasia diagnosed by eus. Gastrointest Endosc. 2009;70:488–94.

    Article  PubMed  Google Scholar 

  43. Goh BK, Ooi LL, Tan YM, Cheow PC, Chung YF, Chow PK, et al. Clinico-pathological features of cystic pancreatic endocrine neoplasms and a comparison with their solid counterparts. Eur J Surg Oncol. 2006;32:553–6.

    Article  CAS  PubMed  Google Scholar 

  44. Ligneau B, Lombard-Bohas C, Partensky C, Valette PJ, Calender A, Dumortier J, et al. Cystic endocrine tumors of the pancreas: clinical, radiologic, and histopathologic features in 13 cases. Am J Surg Pathol. 2001;25:752–60.

    Article  CAS  PubMed  Google Scholar 

  45. Ro C, Chai W, Yu VE, Yu R. Pancreatic neuroendocrine tumors: biology, diagnosis, and treatment. Chin J Cancer. 2013;32:312–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Sheehan MK, Beck K, Pickleman J, Aranha GV. Spectrum of cystic neoplasms of the pancreas and their surgical management. Arch Surg Chicago, Ill: 1960). 2003;138:657–60 (discussion 60–2).

    Article  Google Scholar 

  47. Fernández-del CC, Targarona J, Thayer SP, Rattner DW, Brugge WR, Warshaw AL. Incidental pancreatic cysts: clinicopathologic characteristics and comparison with symptomatic patients. Arch Surg Chicago, Ill: 1960). 2003;138:427–33 (discussion 33–4).

    Article  Google Scholar 

  48. Brugge WR, Lauwers GY, Sahani D, Fernandez-del Castillo C, Warshaw AL. Cystic neoplasms of the pancreas. N Engl J Med. 2004;351:1218–26.

    Article  CAS  PubMed  Google Scholar 

  49. Choi JY, Kim MJ, Lee JY, Lim JS, Chung JJ, Kim KW, et al. Typical and atypical manifestations of serous cystadenoma of the pancreas: Imaging findings with pathologic correlation. AJR Am J Roentgenol. 2009;193:136–42.

    Article  PubMed  Google Scholar 

  50. Sainani NI, Saokar A, Deshpande V, Fernández-del Castillo C, Hahn P, Sahani DV. Comparative performance of mdct and mri with mr cholangiopancreatography in characterizing small pancreatic cysts. AJR Am J Roentgenol. 2009;193:722–31.

    Article  PubMed  Google Scholar 

  51. Goh BK, Tan YM, Chung YF, Chow PK, Cheow PC, Wong WK, et al. A review of mucinous cystic neoplasms of the pancreas defined by ovarian-type stroma: clinicopathological features of 344 patients. World J Surg. 2006;30:2236–45.

    Article  PubMed  Google Scholar 

  52. Yao X, Ji Y, Zeng M, Rao S, Yang B. Solid pseudopapillary tumor of the pancreas: cross-sectional imaging and pathologic correlation. Pancreas. 2010;39:486–91.

    Article  PubMed  Google Scholar 

  53. Mirminachi B, Farrokhzad S, Sharifi AH, Nikfam S, Nikmanesh A, Malekzadeh R, et al. Solid pseudopapillary neoplasm of pancreas; a case series and review literature. Middle East J Dig Dis. 2016;8:102–8.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Kazumori H, Sizuku T, Ueki T, Uchida Y, Yamamoto S. Lymphoepithelial cyst of the pancreas. J Gastroenterol. 1997;32:700–3.

    Article  CAS  PubMed  Google Scholar 

  55. Adsay NV, Hasteh F, Cheng JD, Bejarano PA, Lauwers GY, Batts KP, et al. Lymphoepithelial cysts of the pancreas: a report of 12 cases and a review of the literature. Modern Pathol. 2002;15:492–501.

    Article  Google Scholar 

  56. Rodriguez JR, Salvia R, Crippa S, Warshaw AL, Bassi C, Falconi M, et al. Branch-duct intraductal papillary mucinous neoplasms: observations in 145 patients who underwent resection. Gastroenterology. 2007;133:72–9 (quiz 309–10).

    Article  PubMed  Google Scholar 

  57. Anand N, Sampath K, Wu BU. Cyst features and risk of malignancy in intraductal papillary mucinous neoplasms of the pancreas: a meta-analysis. Clin Gastroenterol Hepatol. 2013;11:913–21 (quiz e59–60).

    Article  PubMed  Google Scholar 

  58. Kim KW, Park SH, Pyo J, Yoon SH, Byun JH, Lee MG, et al. Imaging features to distinguish malignant and benign branch-duct type intraductal papillary mucinous neoplasms of the pancreas: a meta-analysis. Ann Surg. 2014;259:72–81.

    Article  PubMed  Google Scholar 

  59. Kitano M, Sakamoto H, Komaki T, Kudo M. New techniques and future perspective of eus for the differential diagnosis of pancreatic malignancies: Contrast harmonic imaging. Dig Endosc. 2011;23(Suppl 1):46–50.

    Article  PubMed  Google Scholar 

  60. Manfredi R, Ventriglia A, Mantovani W, Mehrabi S, Boninsegna E, Zamboni G, et al. Mucinous cystic neoplasms and serous cystadenomas arising in the body-tail of the pancreas: Mr imaging characterization. Eur Radiol. 2015;25:940–9.

    Article  PubMed  Google Scholar 

  61. Lesniak RJ, Hohenwalter MD, Taylor AJ. Spectrum of causes of pancreatic calcifications. AJR Am J Roentgenol. 2002;178:79–86.

    Article  PubMed  Google Scholar 

  62. Loftus EV Jr, Olivares-Pakzad BA, Batts KP, Adkins MC, Stephens DH, Sarr MG, et al. Intraductal papillary-mucinous tumors of the pancreas: clinicopathologic features, outcome, and nomenclature. Members of the pancreas clinic, and pancreatic surgeons of mayo clinic. Gastroenterology. 1996;110:1909–18.

    Article  PubMed  Google Scholar 

  63. Buetow PC, Buck JL, Pantongrag-Brown L, Beck KG, Ros PR, Adair CF. Solid and papillary epithelial neoplasm of the pancreas: imaging-pathologic correlation on 56 cases. Radiology. 1996;199:707–11.

    Article  CAS  PubMed  Google Scholar 

  64. Kawamoto S, Lawler LP, Horton KM, Eng J, Hruban RH, Fishman EK. Mdct of intraductal papillary mucinous neoplasm of the pancreas: evaluation of features predictive of invasive carcinoma. AJR Am J Roentgenol. 2006;186:687–95.

    Article  PubMed  Google Scholar 

  65. Perez-Johnston R, Narin O, Mino-Kenudson M, Ingkakul T, Warshaw AL, Fernandez-Del Castillo C, et al. Frequency and significance of calcification in ipmn. Pancreatology. 2013;13:43–7.

    Article  CAS  PubMed  Google Scholar 

  66. Poultsides GA, Huang LC, Chen Y, Visser BC, Pai RK, Jeffrey RB, et al. Pancreatic neuroendocrine tumors: radiographic calcifications correlate with grade and metastasis. Ann Surg Oncol. 2012;19:2295–303.

    Article  PubMed  Google Scholar 

  67. Jais B, Rebours V, Malleo G, Salvia R, Fontana M, Maggino L, et al. Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the international association of pancreatology and European pancreatic club (European study group on cystic tumors of the pancreas). Gut. 2016;65:305–12.

    Article  CAS  PubMed  Google Scholar 

  68. Salvia R, Partelli S, Crippa S, Landoni L, Capelli P, Manfredi R, et al. Intraductal papillary mucinous neoplasms of the pancreas with multifocal involvement of branch ducts. Am J Surg. 2009;198:709–14.

    Article  PubMed  Google Scholar 

  69. Horton KM, Hruban RH, Yeo C, Fishman EK. Multi-detector row ct of pancreatic islet cell tumors. Radiographics. 2006;26:453–64.

    Article  PubMed  Google Scholar 

  70. Kawamoto S, Johnson PT, Shi C, Singhi AD, Hruban RH, Wolfgang CL, et al. Pancreatic neuroendocrine tumor with cyst like changes: evaluation with mdct. AJR Am J Roentgenol. 2013;200:W283–W290290.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Fritz S, Schirren M, Klauss M, Bergmann F, Hackert T, Hartwig W, et al. Clinicopathologic characteristics of patients with resected multifocal intraductal papillary mucinous neoplasm of the pancreas. Surgery. 2012;152:S74–80.

    Article  PubMed  Google Scholar 

  72. Sohn TA, Yeo CJ, Cameron JL, Hruban RH, Fukushima N, Campbell KA, et al. Intraductal papillary mucinous neoplasms of the pancreas: an updated experience. Ann Surg. 2004;239:788–97 (discussion 97–9).

    Article  PubMed  PubMed Central  Google Scholar 

  73. Mohr VH, Vortmeyer AO, Zhuang Z, Libutti SK, Walther MM, Choyke PL, et al. Histopathology and molecular genetics of multiple cysts and microcystic (serous) adenomas of the pancreas in von hippel-lindau patients. Am J Pathol. 2000;157:1615–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Hammel PR, Vilgrain V, Terris B, Penfornis A, Sauvanet A, Correas JM, et al. Pancreatic involvement in von hippel-lindau disease. The groupe francophone d'etude de la maladie de von hippel-lindau. Gastroenterology. 2000;119:1087–95.

    Article  CAS  PubMed  Google Scholar 

  75. Kim JA, Blumenfeld JD, Chhabra S, Dutruel SP, Thimmappa ND, Bobb WO, et al. Pancreatic cysts in autosomal dominant polycystic kidney disease: prevalence and association with pkd2 gene mutations. Radiology. 2016;280:762–70.

    Article  PubMed  Google Scholar 

  76. Reddy RP, Smyrk TC, Zapiach M, Levy MJ, Pearson RK, Clain JE, et al. Pancreatic mucinous cystic neoplasm defined by ovarian stroma: Demographics, clinical features, and prevalence of cancer. Clin Gastroenterol Hepatol. 2004;2:1026–31.

    Article  PubMed  Google Scholar 

  77. Tseng JF, Warshaw AL, Sahani DV, Lauwers GY, Rattner DW, Fernandez-del CC. Serous cystadenoma of the pancreas: tumor growth rates and recommendations for treatment. Ann Surg. 2005;242:413–9 (discussion 19–21).

    Article  PubMed  PubMed Central  Google Scholar 

  78. Freeny PC, Saunders MD. Moving beyond morphology: new insights into the characterization and management of cystic pancreatic lesions. Radiology. 2014;272:345–63.

    Article  PubMed  Google Scholar 

  79. Allen PJ, D'Angelica M, Gonen M, Jaques DP, Coit DG, Jarnagin WR, et al. A selective approach to the resection of cystic lesions of the pancreas: results from 539 consecutive patients. Ann Surg. 2006;244:572–82.

    PubMed  PubMed Central  Google Scholar 

  80. Buscaglia JM, Giday SA, Kantsevoy SV, Jagannath SB, Magno P, Wolfgang CL, et al. Patient- and cyst-related factors for improved prediction of malignancy within cystic lesions of the pancreas. Pancreatology. 2009;9:631–8.

    Article  PubMed  Google Scholar 

  81. Di Benedetto F, Ballarin R, De Ruvo N, Berretta M, Spaggiari M, Montalti R, et al. Pancreatic resections for malignancy in patients aged 70 and older. J Am Geriatr Soc. 2009;57:1323–4.

    Article  PubMed  Google Scholar 

  82. Pitman MB, Lewandrowski K, Shen J, Sahani D, Brugge W, Fernandez-del CC. Pancreatic cysts: preoperative diagnosis and clinical management. Cancer Cytopathol. 2010;118:1–13.

    Article  PubMed  Google Scholar 

  83. Kim SY, Lee JM, Kim SH, Shin KS, Kim YJ, An SK, et al. Macrocystic neoplasms of the pancreas: Ct differentiation of serous oligocystic adenoma from mucinous cystadenoma and intraductal papillary mucinous tumor. AJR Am J Roentgenol. 2006;187:1192–8.

    Article  PubMed  Google Scholar 

  84. Stamm BH. Incidence and diagnostic significance of minor pathologic changes in the adult pancreas at autopsy: a systematic study of 112 autopsies in patients without known pancreatic disease. Hum Pathol. 1984;15:677–83.

    Article  CAS  PubMed  Google Scholar 

  85. Sahani DV, Kadavigere R, Blake M, Fernandez-Del Castillo C, Lauwers GY, Hahn PF. Intraductal papillary mucinous neoplasm of pancreas: multi-detector row ct with 2d curved reformations–correlation with mrcp. Radiology. 2006;238:560–9.

    Article  PubMed  Google Scholar 

  86. Singhal D, Kakodkar R, Sud R, Chaudhary A. Issues in management of pancreatic pseudocysts. JOP J Pancreas. 2006;7:502–7.

    Google Scholar 

  87. Rosenberger LH, Stein LH, Witkiewicz AK, Kennedy EP, Yeo CJ. Intraductal papillary mucinous neoplasm (ipmn) with extra-pancreatic mucin: a case series and review of the literature. J Gastrointest Surg. 2012;16:762–70.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji, Fukui, 910-1193, Japan

    Kumi Ozaki, Nobuyuki Kosaka & Hirohiko Kimura

  2. Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan

    Hiroshi Ikeno & Toshifumi Gabata

  3. Department of Diagnostic Pathology, Fukui Prefectural Hospital, Fukui, Japan

    Yasuharu Kaizaki

  4. Department of Surgery, Fukui Prefectural Hospital, Fukui, Japan

    Kazuya Maeda

  5. Department of Pathology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan

    Shohei Higuchi

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  1. Kumi Ozaki
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Ozaki, K., Ikeno, H., Kaizaki, Y. et al. Pearls and pitfalls of imaging features of pancreatic cystic lesions: a case-based approach with imaging–pathologic correlation. Jpn J Radiol 39, 118–142 (2021). https://doi.org/10.1007/s11604-020-01032-1

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