ISSN 1305-3825 | E-ISSN 1305-3612
Abdominal Imaging - Original Article
Solid pseudopapillary neoplasm of the pancreas: CT imaging features and radiological-pathological correlation
1 Department of Diagnostic Imaging, National University Hospital, Singapore; Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore  
2 Department of Diagnostic Imaging, National University Hospital, Singapore.  
3 Department of Pathology, National University Hospital, Singapore and Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore  
Diagn Interv Radiol ; : -

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Abstract

Purpose: To evaluate the imaging features of solid pseudopapillary neoplasm (SPN) of the pancreas with an emphasis on radiological-pathological correlation.

 

Materials and method: Ten patients (all female, average age 32 years) with histological/ cytological diagnosis of SPN encountered between Jan 2007 and Dec 2013 were included in this study. Pre-operative CT images were reviewed for location, attenuation, enhancement pattern, margin, shape, size, morphology, presence of capsule and calcification. CT appearances were correlated with histopathological findings.

 

Results: Tumours in the distal pancreatic body and tail had a tendency to be larger (mean size 12.6 cm vs. 4.0 cm). Six of the nine tumours that were resected had a fibrous pseudocapsule at histology; it could be identified on CT scan in five of them. Eight lesions had mixed hypo-enhancing solid components and cystic areas corresponding to tumour necrosis and haemorrhage. The two smallest lesions were purely solid and non-encapsulated. Varied patterns of calcification were seen in four tumours. Three of the four pancreatic tail tumours invaded the spleen. At a median follow up of 53 months, there was no evidence of recurrence in the nine patients who underwent surgical resection of the tumour.

 

Conclusion:  A mixed solid and cystic pancreatic mass in a young woman is suggestive of SPN. However, smaller lesions may be completely solid. Splenic invasion can occur in pancreatic tail SPNs; however, in this series it did not adversely affect the long term outcome.  

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