GI Section VI: Cystic pancratic Lesions

Question 1

When you see a cystic lesion in the pancreas, by far the most common cause is going to be?

Answer 1

Inflammatory pseudocyst from Acute or Chornic Pancreatitis

Question 2

True epithelial lined cysts are rare, and tend to occur with syndromes such as?

Answer 2

VHL (commonly develop cysts in the kidneys , pancreas , and genital tract)
PKD
CF

Question 3

Answer 3

Serous Cystadenoma

heterogeneous, mixed-density lesion made up of multiple small cysts, which resembles a sponge.

Question 4

Old lady + Multiple heterogeneous cystic lesion

Answer 4

Serous Cystadenoma (Grandma)

Question 5

Pancreatic Cystadenoma are commonly located in which part of the pancreas?

Answer 5

Pancreatic head (70%) (mucinous is almost always in the body or tail)

Question 6

does NOT communicate with the pancreatic duct

Answer 6

Serous Cystanoma (IPMNS do)

Question 7

Old lady + pancreatic mass + Central scar +/- central calcifications =

Answer 7

Serous cystadenoma

Peripheral calcifications = Mucinous calcifications

Question 8

When you see a unilocular cyst with a lobulated contour located in the head of the pancreas, think of?

Answer 8

rare

unilocular macrocystic serous cystadenoma subtype

Question 9

This pre-mahgnant lesion is “always” found in women, usually in their 50s.

Answer 9

Mucinous Cystic Neoplasm (Mother)

Question 10

Mucinous Cystic Neoplasm are located where?

Answer 10

Body and tail (Serous - head)

Question 11

Women + unilocular + Peripheral calcifications

Answer 11

Mucinous Cystic neoplasm
When multilocular (individual cyts tend to be larger than 2 cm)

Question 12

Answer 12

Mucinous Cystic neoplasm

Unilocular cyst in the body/tail
No communication with the pancreatic duct (IPMNs will)

Question 13

Very rare, low grade malignant tumor that occurs almost exclusively in young (30s) females

Answer 13

Solid Pseudopapillary Tumor of the Pancreas (Daughter)

Question 14

Answer 14

Solid Pseudopapillary Tumor of the Pancreas

large at presentation, has a predilection for the tail, and has a “thick capsule.”

Similar to a hemangioma it may demonstrate progressive fill-in of the solid portions.

Question 15

are mucin- producing tumors that ARISE from the duct epithehum

Answer 15

Intraductal Papillary Mucinous Neoplasm

Question 16

Intraductal Papillary Mucinous Neoplasm could be

Answer 16

SIde branch
Main branch

or Both

Question 17

“Thepulmonary nodule o f the pancreas ”

Answer 17

Side Branch IPMN

Question 18

Typically appear as a small cystic mass, often in the head or uncinate process

Answer 18

Side Branch IPMN

Question 19

Lesions less than 3cm, are usually benign

Answer 19

Side Branch IPMN

Question 20

Produces diffuse dilation of the main duct

Answer 20

Main Branch IPMN

Question 21

Atrophy of the gland and dystrophic calcifications may be seen

Answer 21

Main Branch IPMN

mimicking Chronic Pancreatitis

Question 22

Which IMPN has a higher % of malignancy?

Answer 22

Main Branch IPMN

Question 23

All Main Ducts IPMN are considered -

Answer 23

Malignant - Resection should be considered

Question 24

Features Concerning For Malignancy

Answer 24

*Main duct >10 mm (some sources say 1.5 cm)
*Diffuse or multifocal involvement
*Enhancing nodules
*Solid hypovascular mass