Pancreatic cyst Flashcards
1
Q
How are pancreatic cyst mostly identified?
A
- incidentally on abdominal MRI
2
Q
What are the types of pancreatic cyst?
A
- True cyst (non inflammatory)
- Pseudocyst (inflammatory)
3
Q
What are the tow major subtypes of true cyst?
A
- Serous cyst - low risk malignancy
- Mucinous cyst - high risk malignancy
4
Q
What are the clinical features of pancreatic cyst?
A
- Asymptomatic (majority)
- abdominal pain
- back pain
- obstructive jaundice
- vomiting
- systemic features of malignancy
- systemic features of infection (if cyst becomes infected)
5
Q
What is the differential diagnosis of pancreatic cyst?
A
pancreatic pseudocyst
6
Q
Why is it called pancreatic pseudocyst?
A
- lacks epithelial or endothelial cells surrounding the collection
7
Q
What Ix would you order for Pancreatic cyst?
A
- FBC
- U&E
- LFTs
- Tumour markers: CA 19-9
- CT scan
- MRCP
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8
Q
What are the low risk features of pancreatic cyst on imaging?
A
- cyst diameter < 3cm
- cystic morphology with central calcification
- asymptomatic
9
Q
What are the high risk features of pancreatic cyst on imaging?
A
- cyst diameter > 3cm
- pancreatic duct dilation > 10mm
- Enhancing solid component
- non-enhancing mural nodule
10
Q
How would you Mx pancreatic cyst?
A
- Majority: surveillance
- High risk: resection + follow up scan every 2 years
- Low risk: surveillance every 5 years
11
Q
What is pancreatic pseudocyst?
A
- collection of fluid within the pancreatic tissue
- commonly asymptomatic
- tend to be picked up on imaging
