췌장의 낭종성 질환의 감별진단
Differential diagnosis of cystic diseases of pancreas
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초록
Cystic diseases of pancreas are increasingly detected because of high quality of imaging modality. Most of pancreatic cysts are discovered incidentally. Differential diagnosis of pancreatic cysts is very important because they include wide range of pathologic disease such as inflammation, benign neoplasm, borderline and malignant neoplasm. The most common cystic disease of pancreas is post-inflammatory pseudocyst, but in recent decades the incidence of neoplastic cysts, such as serous cyst neoplasm, mucinous cyst neoplasm, intraductal papillary mucinous neoplasm has increased. Among the cystic neoplasms, mucinous cystic neoplasm, intraductal papillary mucinous neoplasm are premalignant, and serous cystadenoma has no malignant potential. Patient’s age, symptoms and a possible history of acute or chronic pancreatitis together with cross-sectional imaging modalities are mainstay for differential diagnosis of cystic diseases of pancreas. Cystic fluid cytology and analysis for CEA, mucin stain, and viscosity are providing additional information for differentiation. But cross-sectional images have overlapping findings in various cystic diseases and cystic fluid aspiration has still lack of sensitivity. The purpose of this review article is to provide the overview of the differentiation of pancreatic cystic lesions.
Abstract
Cystic diseases of pancreas are increasingly detected because of high quality of imaging modality. Most of pancreatic cysts are discovered incidentally. Differential diagnosis of pancreatic cysts is very important because they include wide range of pathologic disease such as inflammation, benign neoplasm, borderline and malignant neoplasm. The most common cystic disease of pancreas is post-inflammatory pseudocyst, but in recent decades the incidence of neoplastic cysts, such as serous cyst neoplasm, mucinous cyst neoplasm, intraductal papillary mucinous neoplasm has increased. Among the cystic neoplasms, mucinous cystic neoplasm, intraductal papillary mucinous neoplasm are premalignant, and serous cystadenoma has no malignant potential. Patient’s age, symptoms and a possible history of acute or chronic pancreatitis together with cross-sectional imaging modalities are mainstay for differential diagnosis of cystic diseases of pancreas. Cystic fluid cytology and analysis for CEA, mucin stain, and viscosity are providing additional information for differentiation. But cross-sectional images have overlapping findings in various cystic diseases and cystic fluid aspiration has still lack of sensitivity. The purpose of this review article is to provide the overview of the differentiation of pancreatic cystic lesions.
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