Pancreas - Part 4 Flashcards
What are clinical findings of a pancreatic cyst? (3)
- Asymptomatic
- Dyspepsia
- Jaundice
What is the US appearance of pancreatic cyst? (3)
- Anechoic mass
- Smooth borders
- Posterior acoustic enhancement
What are 3 differential diagnosis of a pancreatic cyst?
- Fluid-filled stomach 2. Pseudocyst
3. Polycystic disease
What are causes of cystadenoma? (2)
- Microcystic
- accounts for 50% of cystic neoplasms involving the pancreas - Macrocystic
- arise from the ducts
- malignant potential
What are the clinical findings of cystadenoma? (4)
- Asymptomatic
- Abdominal pain
- Palpable mass
- Weight loss
What is the microcystic US appearance of cystadenoma? (2)
- Echogenic
2. Complex mass
What are 4 differential diagnosis of cystadenoma?
- Pseudocyst
- Polycystic disease 3. Abscess
- Fluid-filled stomach
Is a cystadenoma more common in males or females?
Females
What is the macrocystic US appearance of cystadenoma? (4)
- Multiloculated cystic mass
- Irregular margins
- Solid nodules
- Displacement of the CBD, pancreatic duct, and splenic vein may occur
Where is the majority of cystadenoma located?
In the body and tail of the pancreas
What is polycystic disease associated with? (2)
- Polycystic liver
2. Kidney disease
What are the clinical findings of a polycystic disease? (2)
- Asymptomatic
2. Abdominal pain
What is the US appearance of a polycystic disease? (2)
- Multiple cysts
- Associated with multiple cysts in
the liver, kidney, or spleen
What are 3 differential diagnosis of polycystic disease?
- True cyst
- Fluid-filled loops of
bowel - Cystadenoma
What is the 4th most common malignancy?
Carcinoma of the pancreas
What is the cause of pancreatic carcinoma?
Adenocarcinoma
Where is the most common place of a pancreatic carcinoma?
Head of the pancreas
- the body is the next common place
What are the clinical findings of pancreatic carcinoma? (6)
- Abdominal pain
- Severe back pain
- Weight loss
- Painless jaundice
- Anorexia
- New onset of diabetes
What is the US appearance of pancreatic carcinoma? (6)
- Hypo echoic mass in the pancreas
- Irregular borders
- Dilated biliary tree
- Hydropic GB
- Liver metastasis
- Ascites
What are 3 differential diagnosis of pancreatic carcinoma?
- Focal pancreatitis
- Adenoma
- Caudate lobe of the liver
What are 2 types of functional Islet cell tumours?
- Insulinoma
2. Gastrinoma
How much of nonfunctional Islet cell tumour are malignant?
90%
What are the clinical findings of an insulinoma? (5)
- Increase in insulin levels
- Hypoglycemia
- Headaches
- Obesity
- Confusion
What are the clinical findings of an gastrinoma?
Gastric hyperstimulation associated with peptic ulcer disease
What is the Islet cell tumour US appearance? (5)
- Small, well-defined hypo echoic mass
- Large tumours are more echogenic
- Calcifications
- Necrotic cystic areas are more likely malignant
- Majority are hypervascular
What are 3 differential diagnosis of Islet cell tumours?
- Adenoma
- Carcinoma
- Complex cyst
Where are Islet cell tumours most commonly located?
Body or tail
Demonstration of the pancreatic head surrounding the duodenum is consistent with
An annular pancreas
What is the most common complication associated with acute pancreatitis?
Pseudocyst
Where do Islet cells of Langerhans secrete hormones directly into?
The bloodstream
In a Whipple procedure, where does normal pancreatic tissue attached to?
The duodenum
What is the most common cause of acute pancreatitis?
Biliary disease
Is majority of nonfunctioning islet cell tumours benign or malignant?
Malignant
What is the anechoic structure located in the lateral portion of the pancreatic head?
CBD
A sheath of muscle fibers surrounding the distal CBD describes the
Sphincter of Oddi
