Lesson 3B (Part 3) Flashcards
Where are solid pseudopapillary tumours frequently seen?
In young female patients
What % of solid pseudopapillary tumours are malignant?
15%
- increases with age
Where do solid pseudopapillary tumours occur most often?
In the tail of the pancreas
What is the sonographic appearance of solid pseudopapillary tumours? (4)
- Round encapsulated masses
- Variable amounts of necrotic, cystic and soft tissue foci within
3/ Variable echotexture
- anechoic/hypoechoic - Posterior enhancement
What is the sonographic appearance of rare cystic tumours?
There is none
- extremely variable histologic origins
What are 3 types of pancreatic masses?
- Endocrine tumors
- Metastases
- Lipoma
Where do pancreatic endocrine tumours originate?
From the ductal epithelium
What % of pancreatic endocrine tumours are pancreatic neoplasms?
Rare
- 1-5%
What are the 2 different presentations depending on endocrine hyperfunction?
- Hyperfunctioning lesions
2. Non-hyperfunctions
How much do hyperfunctioning lesions comprised of?
90%
- tend to be small
What do hyperfunctioning lesions cause?
Clinical symptoms to come early
What do non hyperfunctioning lesions cause?
No endocrine related symptoms
When are non hyperfunctioning lesions discovered? (2)
- When they are large
2. When they cause pain
What is the sonographic appearance of lipoma? (2)
- Hypoechoic compared to usual echogenic appearance of fat
2. May be mixed or hyperechoic and have internal echoes
What are the most common pancreatic neoplasm seen on autopsy?
Metastatic tumours
- 4x as often as pancreatic cancer
What are the primary sources of metastatic tumours? (6)
- Renal cell carcinoma
- Breast
- Lung
- Colon
- Melanoma
- Stomach
What is a modality that is unreliable in diagnosing fatty replacement?
US
- because it has variable echogenicity
What is a modality that is the best in diagnosing fatty replacement?
CT
What does severe fatty replacement occur with? (5)
- Cystic fibrosis
- Diabetes
- Obesity
- NASH
- Old age
What is a pseudomass caused by?
Fatty sparing in the uncinate process
What is fatty infiltration of the pancreas common in?
Middle aged women
What is the echogenicity of a fatty infiltration?
Moderately echoic pancreas
