CT 101 :Pancreas and Spleen

Size: px
Start display at page:

Download "CT 101 :Pancreas and Spleen"

Transcription

1 CT 101 :Pancreas and Spleen Shikha Khullar,, MD, MPH Division of Radiology University of South Alabama

2

3 The Pancreas

4

5 Normal Pancreas

6 3 Phase Pancreatic CT Non contrast Arterial phase : second delay Venous phase : 70 second delay

7 Arterial Phase Portal vein Celiac Portal vein Spleno-portal confluence SMA CBD SMA SMV

8 Venous Phase Portal vein Celiac Portal vein Spleno-portal confluence SMA CBD SMV SMA

9 Non Contrast Portal vein Celiac Portal vein Spleno-portal confluence SMA CBD SMA

10 Diffuse Pancreatic Disease

11 Pancreatic Atrophy

12 Fatty Infiltration

13 Complete Fatty Replacement

14 Benign inflammatory Diseases Acute pancreatitis Chronic pancreatitis

15 Acute Pancreatitis CT may show normal appearing gland Edematous pancreas Stranding in peripancreatic fat, peritoneal planes Irregular decreased attenuation (edema, focal necrosis) Extension of inflammatory process to anterior pararenel space, colon

16 Acute Pancreatitis

17 Pancreatic Necrosis

18 Chronic Pancreatitis Strong association with alcohol abuse CT appearance Irregular dilatation of pancreatic duct Duct width/ Gland width ratio> 0.5, calcifications May present as focal mass

19 Chronic Pancreatitis

20 Focal Pancreatic Disease

21 Focal Pancreatic Abnormality Solid Mass Adenocarcinoma Islet Cell Tumor Others Cystic Mass Pseudocyst Non Pseudocyst IPMT Cystic Neoplasm Serous cystadenoma Mucinous Adenoma Cystic Adenocarcinoma Things that Simulate Masses Focal Pancreatitis Pancreatic Necrosis Pancreatic Laceration

22 Solid Pancreatic Neoplasms Adenocarcinoma Islet cell tumors

23 Adenocarcinoma Majority (65%) occur in head, present early CT findings Hypo-enhancing mass relative to normal parenchyma Dilated common bile duct Dilated pancreatic duct in body and tail Atrophy or pancreatitis distal to mass Convex uncinate process CT useful for staging, determining resectability

24 Adenocarcinoma

25 Adenocarcinoma

26 Adenocarcinoma

27 Adenocarcinoma Encasing SMA

28 Focal Pancreatic Abnormality Solid Mass Adenocarcinoma Islet Cell Tumor Others Cystic Mass Pseudocyst Non Pseudocyst IPMT Cystic Neoplasm Serous cystadenoma Mucinous Adenoma Cystic Adenocarcinoma Things that Simulate Masses Focal Pancreatitis Pancreatic Necrosis Pancreatic Laceration

29 Islet Cell Tumors Uncommon tumors Most common Insulinomas, gastrinomas Differentiating from adenocarcinoma arterial phase hyperenhancement presence of calcification lack of vascular ecasement absence of central necrosis, cystic change

30 Islet Cell Tumor

31 Glucagonoma

32 Islet Cell Tumor

33 Focal Pancreatic Abnormality Solid Mass Adenocarcinoma Islet Cell Tumor Others Cystic Mass Pseudocyst Non Pseudocyst IPMT Cystic Neoplasm Serous cystadenoma Mucinous Adenoma Cystic Adenocarcinoma Things that Simulate Masses Focal Pancreatitis Pancreatic Necrosis Pancreatic Laceration

34 Cystic Masses: A pseudocyst or not a pseudocyst?? Pseudocyst Non Pseudocyst Intraductal papillary mucinous tumor (IPMT) Cystic neoplasms (Serous cystadenoma, mucinous adenomas) Cystic adenocarcinoma

35 Pseudocyst Collection of pancreatic fluid Lacks septations,, mural nodules Result of acute or chronic pancreatitis or pancreatic trauma If managed non-operatively, operatively, will either spontaneously resolve or remain stable

36 Pseudocyst

37 Chronic Pancreatitis with Pseudocyst

38 Focal Pancreatic Abnormality Solid Mass Adenocarcinoma Islet Cell Tumor Others Cystic Mass Pseudocyst Non Pseudocyst IPMT Cystic Neoplasm Serous cystadenoma Mucinous Adenoma Cystic Adenocarcinoma Things that Simulate Masses Focal Pancreatitis Pancreatic Necrosis Pancreatic Laceration

39 Non Pseudocyst : IPMT Communication with pancreatic duct is diagnostic

40 Non Pseudocyst : IPMT

41 Non Pseudocyst : Cystic Neoplasms 10% of cystic pancreatic masses Two groups Microcystic adenoma (serous cystadenoma) Macrocystic adenoma (mucinous( adenoma)

42 Macrocystic Adenoma

43 The Spleen

44 Is the Spleen Normal?

45 Splenomegaly

46 Accessory Spleens 10-20% of population Usually near hilum Same pattern of enhancement as the spleen Same vascular supply

47 Accessory Spleen

48 Multiple Splenules

49 Autosplenectomy

50 Cystic Splenic Mass Posttraumatic pseudocyst - 80% Final stage in evolution of splenic hematoma Congenital epithelial cysts Hydatid cysts Other cystic masses: Pancreatic pseudocyst Lymphangioma, hemangioma Abscess Hematoma

51 Splenic Cyst

52 Multiple Cysts

53 Solid Splenic Masses Lymphoma Splenic involvement in up to 30% patients Several forms: Homogenous enlargement Miliary nodules Multi focal Single solitary mass

54 Other Solid Splenic Tumors Hemangioendothelioma Angiosarcoma Mesenchymal tumors teratoma) Benign Tumors (hemangioma, lymphangioma) Metastasis tumors (fibrosarcoma,leiomyosarcoma,

55 Splenic Metastasis

56 Splenic Infarcts Embolic disease- cardiac or atherosclerotic origin Sickle cell anemia Wedge shaped, base at capsule and apex towards the hilum

57 Splenic Infarct

58 Traumatic Iaceration

59 Take Home Message. Pathology arising from peripancreatic organs (Common Bile Duct, duodenum, lymph nodes) can be confusing Solid Pancreas Mass : Adenocarcinoma does not enhance on arterial phase while Islet cell tumors show hyperenhancement Cystic pancreas mass : Pseudocyst vs Others Pseudocyst lacks internal septations and nodules

60 Acknowledgements Heidi Umphrey, MD Radiology Resident, University of Alabama at Birmingham Janis O Malley, MD Head, Division of Nuclear Medicine, Department of Radiology, UAB HG Liu Research Associate, Division of Nuclear Medicine, Department of Radiology, UAB

HEPATO-BILIARY IMAGING

HEPATO-BILIARY IMAGING HEPATO-BILIARY IMAGING BY MAMDOUH MAHFOUZ MD PROF.OF RADIOLOGY CAIRO UNIVERSITY mamdouh.m5@gmail.com www.ssregypt.com CT ABDOMEN Indications Patient preparation Patient position Scanogram Fasting 4-6 hours

More information

X-ray Corner. Imaging of The Pancreas. Pantongrag-Brown L

X-ray Corner. Imaging of The Pancreas. Pantongrag-Brown L X-ray Corner 125 Imaging of The Pancreas Modern imaging modalities commonly used in pancreas include ultrasound (US), CT, and MRI. Pancreas is a retroperitoneal organ which makes it difficult to visualize

More information

GASTROINTESTINAL IMAGING STUDY GUIDE

GASTROINTESTINAL IMAGING STUDY GUIDE GASTROINTESTINAL IMAGING STUDY GUIDE Pharynx Diverticula Foreign bodies Trauma o Motility Disorders Esophagus Diverticula Trauma Esophagitis Barrett esophagus Rings, webs, and strictures Varices Benign

More information

Pancreatic Adenocarcinoma: Everything You Need to Know From Cross-Sectional Imaging to Treatment

Pancreatic Adenocarcinoma: Everything You Need to Know From Cross-Sectional Imaging to Treatment Pancreatic Adenocarcinoma: Everything You Need to Know From Cross-Sectional Imaging to Treatment Andrew W. Bowman, MD PhD Assistant Professor of Radiology Mayo Clinic Florida SCBT-MR Annual Meeting Nashville,

More information

Common and unusual CT and MRI manifestations of pancreatic adenocarcinoma: a pictorial review

Common and unusual CT and MRI manifestations of pancreatic adenocarcinoma: a pictorial review Review Article Common and unusual CT and MRI manifestations of pancreatic adenocarcinoma: a pictorial review Min-Jie Yang, Su Li, Yong-Guang Liu, Na Jiao, Jing-Shan Gong Department of Radiology, Shenzhen

More information

X-Ray Corner. Imaging Approach to Cystic Liver Lesions. Pantongrag-Brown L. Solitary cystic liver lesions. Hepatic simple cyst (Figure 1)

X-Ray Corner. Imaging Approach to Cystic Liver Lesions. Pantongrag-Brown L. Solitary cystic liver lesions. Hepatic simple cyst (Figure 1) THAI J 136 Imaging Approach to Cystic Liver Lesions GASTROENTEROL 2013 X-Ray Corner Imaging Approach to Cystic Liver Lesions Pantongrag-Brown L Cystic liver lesions are common findings in daily practice

More information

Radiology Pathology Conference

Radiology Pathology Conference Radiology Pathology Conference Nadia F. Yusaf, M.D. PGY-3 1/29/2010 Presentation material is for education purposes only. All rights reserved. 2010 URMC Radiology Page 1 of 90 Case 1 60 year- old man presents

More information

Dr Claire Smith, Consultant Radiologist St James University Hospital Leeds

Dr Claire Smith, Consultant Radiologist St James University Hospital Leeds Dr Claire Smith, Consultant Radiologist St James University Hospital Leeds Imaging in jaundice and 2ww pathway Image protocol Staging Limitations Pancreatic cancer 1.2.4 Refer people using a suspected

More information

Malignant Focal Liver Lesions

Malignant Focal Liver Lesions Malignant Focal Liver Lesions Other Than HCC Pablo R. Ros, MD, MPH, PhD Departments of Radiology and Pathology University Hospitals Cleveland Medical Center Case Western Reserve University Pablo.Ros@UHhospitals.org

More information

Pancreas Quizzes c. Both A and B a. Directly into the blood stream (not using ducts)

Pancreas Quizzes c. Both A and B a. Directly into the blood stream (not using ducts) Pancreas Quizzes Quiz 1 1. The pancreas produces hormones. Which type of hormone producing organ is the pancreas? a. Endocrine b. Exocrine c. Both A and B d. Neither A or B 2. Endocrine indicates hormones

More information

Evaluation and Management of Cystic Lesions of the Pancreas: When to Resect, When to Follow and When to Forget

Evaluation and Management of Cystic Lesions of the Pancreas: When to Resect, When to Follow and When to Forget Evaluation and Management of Cystic Lesions of the Pancreas: When to Resect, When to Follow and When to Forget Randall Brand, MD Professor of Medicine Division of Gastroenterology, Hepatology and Nutrition

More information

Contrast-Enhanced Ultrasonograpic Findings in Pancreatic Tumors

Contrast-Enhanced Ultrasonograpic Findings in Pancreatic Tumors Int. J. Med. Sci. 2008, 5 203 Short Research Communication International Journal of Medical Sciences ISSN 1449-1907 www.medsci.org 2008 5(4):203-208 Ivyspring International Publisher. All rights reserved

More information

40th European Congress of Cytology Liverpool, UK, 2-5 th October 2016

40th European Congress of Cytology Liverpool, UK, 2-5 th October 2016 40th European Congress of Cytology Liverpool, UK, 2-5 th October 2016 EUS FNA of abdominal organs: An approach to reporting and triage for ancillary testing Date and time: Sunday 2 nd October 2016 15.00-16.30

More information

Cystic Pancreatic Lesions: Approach to Diagnosis

Cystic Pancreatic Lesions: Approach to Diagnosis Cystic Pancreatic Lesions: Approach to Diagnosis Poster No.: R-0130 Congress: RANZCR-AOCR 2012 Type: Educational Exhibit Authors: A. AGARWAL, R. M. Mendelson; Perth/AU Keywords: Cysts, Biopsy, Endoscopy,

More information

Pediatric Hepatobiliary, Pancreatic & Splenic US

Pediatric Hepatobiliary, Pancreatic & Splenic US Pediatric Hepatobiliary, Pancreatic & Splenic US Susan J. Back, MD Department of Radiology, The Children s Hospital of Philadelphia No Disclosures Objectives Normal Abnormal: cases and US advances Objectives

More information

Evaluation of Suspected Pancreatic Cancer

Evaluation of Suspected Pancreatic Cancer Evaluation of Suspected Pancreatic Cancer October 15, 2015 If you experience technical difficulty during the presentation: Contact WebEx Technical Support directly at: US Toll Free: 1-866-779-3239 Toll

More information

Autoimmune Pancreatitis: A Great Imitator

Autoimmune Pancreatitis: A Great Imitator Massachusetts General Hospital Harvard Medical School Autoimmune Pancreatitis: A Great Imitator Dushyant V Sahani MD dsahani@partners.org Autoimmune Pancreatitis: Learning Objectives Clinical manifestations

More information

The Pancreas. Basic Anatomy. Endocrine pancreas. Exocrine pancreas. Pancreas vasculature. Islets of Langerhans. Acinar cells Ductal System

The Pancreas. Basic Anatomy. Endocrine pancreas. Exocrine pancreas. Pancreas vasculature. Islets of Langerhans. Acinar cells Ductal System SGNA: Back to Basics Rogelio G. Silva, MD Assistant Clinical Professor of Medicine University of Illinois at Chicago Department of Medicine Division of Gastroenterology Advocate Christ Medical Center GI

More information

The Spleen. Dr Fahad Ullah

The Spleen. Dr Fahad Ullah The Spleen BY Dr Fahad Ullah Spleen The spleen is an largest lymphoid organ shaped like a shoe that lies relative to the 9th and 11th ribs and is located in the left hypochondrium. Thus, the spleen is

More information

Role of Imaging Methods in Diagnosis of Acute Pancreatitis. Válek V. Radiologická klinika, FN Brno a LF MU v Brně

Role of Imaging Methods in Diagnosis of Acute Pancreatitis. Válek V. Radiologická klinika, FN Brno a LF MU v Brně Role of Imaging Methods in Diagnosis of Acute Pancreatitis Válek V. Radiologická klinika, FN Brno a LF MU v Brně New Classification: Acute Pancreatitis 2007 revision of Atlanta classification and definitions

More information

Chief Complaint. Retroperitoneal cystic mass incidentally found at health examination center.

Chief Complaint. Retroperitoneal cystic mass incidentally found at health examination center. Personal Information Age: 34 y/o Sex: female Past history: major systemic medical history(-) surgical history(-), family history(-) Denied food or drug allergy Chief Complaint Retroperitoneal cystic mass

More information

Cystic Lesions of the Pancreas

Cystic Lesions of the Pancreas Residents Section Pattern of the Month w668 04.29.11 Khan et al. Residents Section Pattern of the Month Residents inradiology tif Khan 1 Faisal Khosa Ronald L. Eisenberg Khan, Khosa F, Eisenberg RL Keywords:

More information

Accessory Glands of Digestive System

Accessory Glands of Digestive System Accessory Glands of Digestive System The liver The liver is soft and pliable and occupies the upper part of the abdominal cavity just beneath the diaphragm. The greater part of the liver is situated under

More information

CT & MRI of Benign Liver Neoplasms Srinivasa R Prasad

CT & MRI of Benign Liver Neoplasms Srinivasa R Prasad CT & MRI of Benign Liver Neoplasms Srinivasa R Prasad No financial disclosures Acknowledgements Many thanks to Drs. Heiken, Narra & Menias (MIR) Dr. Sahani (MGH) for sharing images Benign Liver Tumors:

More information

Imaging of common diseases of hepatobiliary and GI system

Imaging of common diseases of hepatobiliary and GI system Imaging of common diseases of hepatobiliary and GI system Natthaporn Tanpowpong, M.D. Diagnostic radiology Faculty of Medicine, Chulalongkorn University Normal plain radiograph A = Common bile duct

More information

4/9/2018 OBJECTIVES PANCREAOTO BILIARY ULTRASOUND: BEYOND CHOLECYSTITIS

4/9/2018 OBJECTIVES PANCREAOTO BILIARY ULTRASOUND: BEYOND CHOLECYSTITIS PANCREAOTO BILIARY ULTRASOUND: BEYOND CHOLECYSTITIS Jean Yves Sewah Kaiser Permanente West Los Angeles 1 OBJECTIVES Discuss the role of ultrasound in the evaluation of the gallbladder, biliary tree and

More information

'Pan' Modality Imaging of the Pancreas and Pathologies.

'Pan' Modality Imaging of the Pancreas and Pathologies. 'Pan' Modality Imaging of the Pancreas and Pathologies. Poster No.: C-2650 Congress: ECR 2013 Type: Educational Exhibit Authors: R. P. Patel, S. Barrett, J. Coyle, A. Buckley, W. C. Yee, A. 1 2 4 1 3 2

More information

Anatomy of the biliary tract

Anatomy of the biliary tract Harvard-MIT Division of Health Sciences and Technology HST.121: Gastroenterology, Fall 2005 Instructors: Dr. Jonathan Glickman Anatomy of the biliary tract Figure removed due to copyright reasons. Biliary

More information

Radiology of hepatobiliary diseases

Radiology of hepatobiliary diseases GI cycle - Lecture 14 436 Teams Radiology of hepatobiliary diseases Objectives 1. To Interpret plan x-ray radiograph of abdomen with common pathologies. 2. To know the common pathologies presentation.

More information

Introduction. Splenic pathologies. Polysplenia syndrome. Anatomical variants 21/08/2017. Ultrasound of the forgotten organ of the abdomen: the spleen

Introduction. Splenic pathologies. Polysplenia syndrome. Anatomical variants 21/08/2017. Ultrasound of the forgotten organ of the abdomen: the spleen Ultrasound of the forgotten organ of the abdomen: the spleen Olivier Lucidarme Pitié Salpêtrière UPMC/Sorbonne University Paris France Malformations Introduction must look for other malformations frequently

More information

Pancreatic Cystic Lesions 원자력병원

Pancreatic Cystic Lesions 원자력병원 Pancreatic Cystic Lesions 원자력병원 박선 후 Lines of cellular differentiation Ductal Acinar Undetermined Ductal adenocarcinoma Serous/ mucinous tumor Intraductal papillary mucinous neoplasm Acinar cell carcinoma

More information

Splenic Cystic Lesions - Differential Diagnosis

Splenic Cystic Lesions - Differential Diagnosis Splenic Cystic Lesions - Differential Diagnosis Poster No.: C-1343 Congress: ECR 2013 Type: Educational Exhibit Authors: N. Neto, P. G. M. G. Ferreira, A. Vasconcelos ; Lisboa/PT, 1 2 2 3 1 3 Amadora/PT,

More information

Unusual Pancreatic Neoplasms RTC 2/11/2011

Unusual Pancreatic Neoplasms RTC 2/11/2011 Unusual Pancreatic Neoplasms RTC 2/11/2011 Objectives Intraductal Papillary Mucinous Neoplasm (IPMN) Mucinous Cystic Neoplasm (MCN) Islet Cell Tumors Insulinoma Glucagonoma VIPoma Somatostatinoma Gastrinoma

More information

Neuro-endocrine and pancreatic non-adenocarcinomas. Marc Engelbrecht, AMC, Amsterdam

Neuro-endocrine and pancreatic non-adenocarcinomas. Marc Engelbrecht, AMC, Amsterdam Neuro-endocrine and pancreatic non-adenocarcinomas Marc Engelbrecht, AMC, Amsterdam Pancreatic Tumors q Epithelial Exocrine q Mesenchymal Ductal Adenocarcinoma (85-95%) Metastasis Lymfoma Acinar Cell Carcinoma

More information

Normal Sonographic Anatomy

Normal Sonographic Anatomy hapter 2:The Liver DUNSTAN ABRAHAM Normal Sonographic Anatomy Homogeneous, echogenic texture (Figure 2-1) Measures approximately 15 cm in length and 10 12.5 cm anterior to posterior; measurement taken

More information

Pancreatic tumors: review and keys for differential diagnosis

Pancreatic tumors: review and keys for differential diagnosis Pancreatic tumors: review and keys for differential diagnosis Poster No.: C-2172 Congress: ECR 2015 Type: Educational Exhibit Authors: J. Silva 1, P. L. Arenas Garcia 1, P. Ramos Lopez 1, M. Gamo 2, C.

More information

Objectives. Intraoperative Consultation of the Whipple Resection Specimen. Pancreas Anatomy. Pancreatic ductal carcinoma 11/10/2014

Objectives. Intraoperative Consultation of the Whipple Resection Specimen. Pancreas Anatomy. Pancreatic ductal carcinoma 11/10/2014 Intraoperative Consultation of the Whipple Resection Specimen Pathology Update Faculty of Medicine, University of Toronto November 15, 2014 John W. Wong, MD, FRCPC Department of Anatomical Pathology Sunnybrook

More information

Imaging of liver and pancreas

Imaging of liver and pancreas Imaging of liver and pancreas.. Disease of the liver Focal liver disease Diffusion liver disease Focal liver disease Benign Cyst Abscess Hemangioma FNH Hepatic adenoma HCC Malignant Fibrolamellar carcinoma

More information

Kenneth D. Chi, MD Medical Director GI Lab Advocate Lutheran General Hospital

Kenneth D. Chi, MD Medical Director GI Lab Advocate Lutheran General Hospital Kenneth D. Chi, MD Medical Director GI Lab Advocate Lutheran General Hospital Advances in Digestive Health for the Primary Care Physician Symposium May 2, 2015 None Case Presentation Types of Pancreatic

More information

ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts

ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts Grace H. Elta, MD, FACG 1, Brintha K. Enestvedt, MD, MBA 2, Bryan G. Sauer, MD, MSc, FACG (GRADE Methodologist) 3 and Anne Marie Lennon,

More information

Guidelines, Policies and Statements D5 Statement on Abdominal Scanning

Guidelines, Policies and Statements D5 Statement on Abdominal Scanning Guidelines, Policies and Statements D5 Statement on Abdominal Scanning Disclaimer and Copyright The ASUM Standards of Practice Board have made every effort to ensure that this Guideline/Policy/Statement

More information

Financial Disclosure

Financial Disclosure Benign Liver Masses Adil Abdalla, MBBS Creighton University-CHI Health August 25, 2018 Financial Disclosure Nothing to disclose Financial Disclosure 1 Objectives To assess patients with benign liver tumors

More information

5/17/2013. Pancreatic Cancer. Postgraduate Course in General Surgery CASE 1: CASE 1: Overview. Case presentation. Differential diagnosis

5/17/2013. Pancreatic Cancer. Postgraduate Course in General Surgery CASE 1: CASE 1: Overview. Case presentation. Differential diagnosis Overview Case presentation Postgraduate Course in General Surgery Differential diagnosis Diagnosis and therapy Eric K. Nakakura Koloa, HI March 26, 2013 Outcomes CASE 1: CASE 1: A 78-year-old man developed

More information

Select problems in cystic pancreatic lesions

Select problems in cystic pancreatic lesions Disclosure Select problems in cystic pancreatic lesions Five Prime Therapeutics shareholder Adicet Bio shareholder Bristol-Meyer Squibb advisory board grace.kim@ucsf.edu Pancreatic cystic lesions Intraductal

More information

Spectrum of Causes of Pancreatic Calcifications

Spectrum of Causes of Pancreatic Calcifications Pictorial Essay Downloaded from www.ajronline.org by 46.3.200.2 on 12/21/17 from IP address 46.3.200.2. Copyright RRS. For personal use only; all rights reserved Spectrum of Causes of Pancreatic Calcifications

More information

3/28/2012. Periampullary Tumors. Postgraduate Course in General Surgery CASE 1: CASE 1: Overview. Eric K. Nakakura Ko Olina, HI

3/28/2012. Periampullary Tumors. Postgraduate Course in General Surgery CASE 1: CASE 1: Overview. Eric K. Nakakura Ko Olina, HI Overview Postgraduate Course in General Surgery Case presentation Differential diagnosis Diagnosis and therapy Outcomes Principles of palliative care Eric K. Nakakura Ko Olina, HI March 27, 2012 CASE 1:

More information

ACUTE PANCREATITIS: NEW CLASSIFICATION OF AN OLD FOE. T Barrow, A Nasrullah, S Liong, V Rudralingam, S A Sukumar

ACUTE PANCREATITIS: NEW CLASSIFICATION OF AN OLD FOE. T Barrow, A Nasrullah, S Liong, V Rudralingam, S A Sukumar ACUTE PANCREATITIS: NEW CLASSIFICATION OF AN OLD FOE T Barrow, A Nasrullah, S Liong, V Rudralingam, S A Sukumar LEARNING OBJECTIVES q Through a series of cases illustrate the updated Atlanta symposium

More information

The role of endoscopy in the diagnosis and treatment of cystic pancreatic neoplasms

The role of endoscopy in the diagnosis and treatment of cystic pancreatic neoplasms The role of endoscopy in the diagnosis and treatment of cystic pancreatic neoplasms CYSTIC LESIONS AND FLUID COLLECTIONS OF THE PANCREAS Their pathology ranges from pseudocysts and pancreatic necrosis

More information

Appendix 5. EFSUMB Newsletter. Gastroenterological Ultrasound

Appendix 5. EFSUMB Newsletter. Gastroenterological Ultrasound EFSUMB Newsletter 87 Examinations should encompass the full range of pathological conditions listed below A log book listing the types of examinations undertaken should be kept Training should usually

More information

Contents. Basic Ultrasound Principles and Terminology. Ultrasound Nodule Characteristics

Contents. Basic Ultrasound Principles and Terminology. Ultrasound Nodule Characteristics Contents Basic Ultrasound Principles and Terminology Basic Ultrasound Principles... 1 Ultrasound System... 2 Linear Transducer for Superficial Images and Ultrasound-Guided FNA... 3 Scanning Planes... 4

More information

Laparoscopic & Robotic Surgery in Pancreas Disease

Laparoscopic & Robotic Surgery in Pancreas Disease 2007 년도대한췌담도학회추계학술대회 Session IV: Recent Updates in Pancreatobiliary Diseases Laparoscopic & Robotic Surgery in Pancreas Disease Department of Surgery, Yonsei University College of Medicine, Korea Woo-Jung

More information

Steven Herwick 1 Frank H. Miller Ana L. Keppke

Steven Herwick 1 Frank H. Miller Ana L. Keppke Herwick et al. MRI of Islet ell Tumors of the Pancreas bdominal Imaging Pictorial Essay Downloaded from www.ajronline.org by 37.44.203.29 on 02/19/18 from IP address 37.44.203.29. opyright RRS. For personal

More information

Pancreatic Cysts. Darius C. Desai, MD FACS St. Luke s University Health Network

Pancreatic Cysts. Darius C. Desai, MD FACS St. Luke s University Health Network Pancreatic Cysts Darius C. Desai, MD FACS St. Luke s University Health Network None Disclosures Incidence Widespread use of cross sectional imaging Seen in over 2% of patients having abdominal imaging

More information

Pancreatic Lesions. Valerie Jefford Pediatric Surgery Rounds June 6, 2003

Pancreatic Lesions. Valerie Jefford Pediatric Surgery Rounds June 6, 2003 Pancreatic Lesions Valerie Jefford Pediatric Surgery Rounds June 6, 2003 Embryology 4 th week 2 buds of endodermal origin from caudal foregut Dorsal and ventral bud Ventral migrates dorsally with CBD (below/behind

More information

CT abdomen and pelvis

CT abdomen and pelvis CT abdomen and pelvis General indications: Assessment of vague abdominal symptoms (pain, colics,distenstion,...) Varifecation of a lesion discovered by other diagnostic modalities as US, barium,ivp, Staging

More information

General Surgery PURPLE SERVICE MUHC-RVH Site

General Surgery PURPLE SERVICE MUHC-RVH Site Preamble HPB is a clinical teaching unit with several different vocations: It regroups all solid organ Transplantation as well as most advanced Hepatobiliary and Pancreatic clinical activities performed

More information

Gemstone Spectral Imaging quantifies lesion characteristics for a confident diagnosis

Gemstone Spectral Imaging quantifies lesion characteristics for a confident diagnosis GE Healthcare Gemstone Spectral Imaging quantifies lesion characteristics for a confident diagnosis CT clinical case study lesion characterization Desiree Morgan, MD Vice Chair of Clinical Research Professor

More information

21/07/2017. CS Verbeke. Non-neoplastic disease of the pancreas PATHOLOGY OF NON-NEOPLASTIC PANCREATIC DISEASES

21/07/2017. CS Verbeke. Non-neoplastic disease of the pancreas PATHOLOGY OF NON-NEOPLASTIC PANCREATIC DISEASES Non-neoplastic disease of the pancreas No indication for surgical resection of non-neoplastic disease (except end-stage chronic pancreatitis) Unexpected benign disease in 5-13% of pancreatic resections

More information

Management A Guideline Based Approach to the Incidental Pancreatic Cysts. Common Cystic Pancreatic Neoplasms.

Management A Guideline Based Approach to the Incidental Pancreatic Cysts. Common Cystic Pancreatic Neoplasms. Management 2016 A Guideline Based Approach to the Incidental Pancreatic Cysts ISMRM 2016 Masoom Haider, MD, FRCP(C) Professor of Radiology, University of Toronto Clinician Scientist, Ontario Institute

More information

Evidence based imaging of the pancreas

Evidence based imaging of the pancreas Evidence based imaging of the pancreas D.Vanbeckevoort, D.Bielen, K.Op de beeck, R.Vanslembrouck Department of Radiology Chairman Prof. Dr. R.Oyen Non-invasive imaging tests available for the diagnosis

More information

Neoplasias Quisticas del Páncreas

Neoplasias Quisticas del Páncreas SEAP -Aproximación Práctica a la Patología Gastrointestinal- Madrid, 26 de mayo, 2006 Neoplasias Quisticas del Páncreas Gregory Y. Lauwers, M.D. Director, Service Massachusetts General Hospital Harvard

More information

Vascular Imaging in the Pediatric Abdomen. Jonathan Swanson, MD

Vascular Imaging in the Pediatric Abdomen. Jonathan Swanson, MD Vascular Imaging in the Pediatric Abdomen Jonathan Swanson, MD Goals and Objectives To understand the imaging approach, appearance, and clinical manifestations of the common pediatric abdominal vascular

More information

Appendix 4: WHO Classification of Tumours of the pancreas 17

Appendix 4: WHO Classification of Tumours of the pancreas 17 S3.01 The WHO histological tumour type must be recorded. CS3.01a The histological type of the tumour should be recorded based on the current WHO classification 17 (refer to Appendices 4-7). Appendix 4:

More information

Imaging in gastric cancer

Imaging in gastric cancer Imaging in gastric cancer Gastric cancer remains a deadly disease because of late diagnosis. Adenocarcinoma represents 90% of malignant tumors. Diagnosis is based on endoscopic examination with biopsies.

More information

Morphologic features in cystic lesions of pancreas-a retrospective analysis

Morphologic features in cystic lesions of pancreas-a retrospective analysis International Journal of Advances in Medicine Cicy PJ et al. Int J Adv Med. 2018 Feb;5(1):192-196 http://www.ijmedicine.com pissn 2349-3925 eissn 2349-3933 Original Research Article DOI: http://dx.doi.org/10.18203/2349-3933.ijam20180083

More information

Management of Pancreatic Islet Cell Tumors

Management of Pancreatic Islet Cell Tumors Management of Pancreatic Islet Cell Tumors Ravi Dhanisetty, MD November 5, 2009 Morbidity and Mortality Conference Case Presentation 42 yr female with chronic abdominal pain. PMHx: Uterine fibroids Medications:

More information

Leonard M. Glassman MD

Leonard M. Glassman MD BI-RADS The New BI-RADS Leonard M. Glassman MD FACR Former Chief of Breast Imaging American Institute for Radiologic Pathology Washington Radiology Associates, PC Breast Imaging Reporting and Data System

More information

Cystic pancreatic lesions A proposal for a network approach. Chris Briggs Consultant HPB Surgeon Peninsula HPB Unit Derriford Hospital, Plymouth

Cystic pancreatic lesions A proposal for a network approach. Chris Briggs Consultant HPB Surgeon Peninsula HPB Unit Derriford Hospital, Plymouth Cystic pancreatic lesions A proposal for a network approach Chris Briggs Consultant HPB Surgeon Peninsula HPB Unit Derriford Hospital, Plymouth Aims Brief overview of cystic pancreatic lesions International

More information

Hilar cholangiocarcinoma. Frank Wessels, Maarten van Leeuwen, UMCU utrecht

Hilar cholangiocarcinoma. Frank Wessels, Maarten van Leeuwen, UMCU utrecht Hilar cholangiocarcinoma Frank Wessels, Maarten van Leeuwen, UMCU utrecht Content Anatomy Biliary strictures (Hilar) Cholangiocarcinoom Staging Biliary tract 1 st order Ductus hepatica dextra Ductus hepaticus

More information

Anatomical and Functional MRI of the Pancreas

Anatomical and Functional MRI of the Pancreas Anatomical and Functional MRI of the Pancreas MA Bali, MD, T Metens, PhD Erasme Hospital Free University of Brussels Belgium mbali@ulb.ac.be Introduction The use of MRI to investigate the pancreas has

More information

Hepatobiliary and Pancreatic Malignancies

Hepatobiliary and Pancreatic Malignancies Hepatobiliary and Pancreatic Malignancies Gareth Eeson MD MSc FRCSC Surgical Oncologist and General Surgeon Kelowna General Hospital Interior Health Consultant, Surgical Oncology BC Cancer Agency Centre

More information

Imaging of Neuroendocrine Metastases

Imaging of Neuroendocrine Metastases Imaging of Neuroendocrine Metastases Aoife Kilcoyne, Shaunagh McDermott, Colin McCarthy,Manuel Patino, Dushyant Sahani, Michael Blake Abdominal Imaging Division Massachusetts General Hospital Disclosure

More information

Intraductal papillary mucinous neoplasm of the bile ducts: a rare form of premalignant lesion of invasive cholangiocarcinoma

Intraductal papillary mucinous neoplasm of the bile ducts: a rare form of premalignant lesion of invasive cholangiocarcinoma Intraductal papillary mucinous neoplasm of the bile ducts: a rare form of premalignant lesion of invasive cholangiocarcinoma Authors: R. Revert Espí, Y. Fernandez Nuñez, I. Carbonell, D. P. Gómez valencia,

More information

Imaging abdominal vascular emergencies. V.Stoynova

Imaging abdominal vascular emergencies. V.Stoynova Imaging abdominal vascular emergencies V.Stoynova Abdominal vessels V. Stoynova 2 Acute liver bleeding trauma anticoagulant therapy liver disease : HCC, adenoma, meta, FNH, Hemangioma Diagnosis :CT angiography

More information

Sex: 女 Age: 51 Occupation: 無 Admission date:92/07/22

Sex: 女 Age: 51 Occupation: 無 Admission date:92/07/22 Sex: 女 Age: 51 Occupation: 無 Admission date:92/07/22 Chief complaint Unknown fever for one month Hand tremor and left huge renal tumor was noted Present illness Suffered from fever for one month, hand

More information

Appendix 9: Endoscopic Ultrasound in Gastroenterology

Appendix 9: Endoscopic Ultrasound in Gastroenterology Appendix 9: Endoscopic Ultrasound in Gastroenterology This curriculum is intended for clinicians who perform endoscopic ultrasonography (EUS) in gastroenterology. It includes standards for theoretical

More information

Lesions of the pancreaticoduodenal groove, a pictorial review

Lesions of the pancreaticoduodenal groove, a pictorial review Lesions of the pancreaticoduodenal groove, a pictorial review Poster No.: C-2131 Congress: ECR 2013 Type: Educational Exhibit Authors: E. Ni Mhurchu, L. Lavelle, I. Murphy, S. Skehan ; IE, Dublin/ IE Keywords:

More information

Pancreas Case Scenario #1

Pancreas Case Scenario #1 Pancreas Case Scenario #1 An 85 year old white female presented to her primary care physician with increasing abdominal pain. On 8/19 she had a CT scan of the abdomen and pelvis. This showed a 4.6 cm mass

More information

Chronic pancreatitis mimicking intraductal papillary mucinous neoplasm of the pancreas; Report of tow cases

Chronic pancreatitis mimicking intraductal papillary mucinous neoplasm of the pancreas; Report of tow cases Jichi Medical University Journal Chronic pancreatitis mimicking intraductal papillary mucinous neoplasm of the pancreas; Report of tow cases Noritoshi Mizuta, Hiroshi Noda, Nao Kakizawa, Nobuyuki Toyama,

More information

Biliary tract tumors

Biliary tract tumors Short Course 2010 Annual Fall Meeting of the Korean Society for Pathologists Biliary tract tumors Joon Hyuk Choi, M.D., Ph.D. Professor, Department of Pathology, Yeungnam Univ. College of Medicine, Daegu,

More information

Primary Pancreatic Lymphoma - CT Imaging Features and Differential Diagnosis

Primary Pancreatic Lymphoma - CT Imaging Features and Differential Diagnosis Primary Pancreatic Lymphoma - CT Imaging Features and Differential Diagnosis Poster No.: C-1644 Congress: ECR 2015 Type: Educational Exhibit Authors: A. T. Radu, M. C. Stefan, A.-M. Bratu, C. Zaharia;

More information

Policies, Standards, and Guidelines. Guidelines for Abdominal Ultrasound Examination

Policies, Standards, and Guidelines. Guidelines for Abdominal Ultrasound Examination Policies, Standards, and Guidelines Guidelines for Abdominal Ultrasound Examination Approved by Council Feb 2018 Disclaimer and Copyright The ASUM Standards of Practice Board have made every effort to

More information

Essentials of Clinical MR, 2 nd edition. 65. Benign Hepatic Masses

Essentials of Clinical MR, 2 nd edition. 65. Benign Hepatic Masses 65. Benign Hepatic Masses Pulse sequences acquired for abdominal MRI typically consist of fast acquisition schemes such as single-shot turbo spin echo (i.e. HASTE) and gradient echo schemes such as FLASH

More information

Case Scenario 1. Discharge Summary

Case Scenario 1. Discharge Summary Case Scenario 1 Discharge Summary A 69-year-old woman was on vacation and noted that she was becoming jaundiced. Two months prior to leaving on that trip, she had had a workup that included an abdominal

More information

Radiological Analysis of Cystic lesions of the Pancreas

Radiological Analysis of Cystic lesions of the Pancreas September 2002 Radiological Analysis of Cystic lesions of the Pancreas Shruthi Mahalingaiah, Harvard Medical School Year III, Agenda Background Anatomy and histology Radiological workup of a cyst in the

More information

Contrast Enhanced Ultrasound of Parenchymal Masses in Children

Contrast Enhanced Ultrasound of Parenchymal Masses in Children Contrast Enhanced Ultrasound of Parenchymal Masses in Children Sue C Kaste, DO On behalf of Beth McCarville, MD St. Jude Children s Research Hospital Memphis, TN Overview Share St. Jude experience with

More information

Multiple Primary Quiz

Multiple Primary Quiz Multiple Primary Quiz Case 1 A 72 year old man was found to have a 12 mm solid lesion in the pancreatic tail by computed tomography carried out during a routine follow up study of this patient with adult

More information

An Approach to Pancreatic Cysts. Introduction

An Approach to Pancreatic Cysts. Introduction An Approach to Pancreatic Cysts Nalini M. Guda, MD Aurora St. Luke s Medical Center, Milwaukee Clinical Adjunct Professor of Medicine, University of Wisconsin School of Medicine and Public Health Introduction

More information

Matthew McCollough, M.D. April 9, 2009 University of Louisville

Matthew McCollough, M.D. April 9, 2009 University of Louisville Matthew McCollough, M.D. April 9, 2009 University of Louisville List the differential diagnosis for pancreatic cysts Review the epidemiology Illustrate the types of cysts through case discussions Discuss

More information

Cystic lesions of the pancreato-duodenal confluence. Who is who?

Cystic lesions of the pancreato-duodenal confluence. Who is who? Cystic lesions of the pancreato-duodenal confluence. Who is who? Poster No.: C-0183 Congress: ECR 2014 Type: Educational Exhibit Authors: L. Goiburu Gonzalez, M. Paraira Beser, A. Pedrerol Perez, 1 3 1

More information

Frank Burton Memorial Update on Pancreato-biliary Cancers

Frank Burton Memorial Update on Pancreato-biliary Cancers Frank Burton Memorial Update on Pancreato-biliary Cancers Diagnosis and management of pancreatic cancer: common dilemmas Moderators: Banke Agarwal, MD Paul Buse, MD Evaluation of patients with obstructive

More information

Q&A Session NAACCR Webinar Series Collecting Cancer Data: Pancreas January 05, 2012

Q&A Session NAACCR Webinar Series Collecting Cancer Data: Pancreas January 05, 2012 Q&A Session NAACCR Webinar Series Collecting Cancer Data: Pancreas January 05, 2012 Q: Will sticky notes be transferrable from the previous electronic version of CS to the updated version? A: It is our

More information

Intro to Gallbladder & Pancreas Pathology

Intro to Gallbladder & Pancreas Pathology Cholecystitis acute chronic Gallbladder tumors Adenomyoma (benign) Adenocarcinoma Pancreatitis acute chronic Pancreatic tumors Intro to Gallbladder & Pancreas Pathology Helen Remotti M.D. Gallstones (Cholelithiasis)

More information

Interactive Exhibit On Imaging Updates For Staging And Response Assessment In Pancreatic Cancer

Interactive Exhibit On Imaging Updates For Staging And Response Assessment In Pancreatic Cancer Interactive Exhibit On Imaging Updates For Staging And Response Assessment In Pancreatic Cancer 1 Vinit Baliyan, MD; 1 Hamed Kordbacheh, MD; 2 Eric P Tamm, MD; 3 Theodore S Hong, MD; 4 Carlos Fernandez-Del

More information

Small Plicae Circularis. Short Closely packed together. Sparse, completely absent at distal part Lymphoid Nodule

Small Plicae Circularis. Short Closely packed together. Sparse, completely absent at distal part Lymphoid Nodule Intestines Differences Between Jejunum and Ileum Types Jejunum Ileum Color Deeper red Paler pink Calibre Bigger Smaller Thickness of wall Thick and Heavy Thin and Lighter Vascularity Highly vascularised

More information

Evaluation of Liver Mass Lesions. American College of Gastroenterology 2013 Regional Postgraduate Course

Evaluation of Liver Mass Lesions. American College of Gastroenterology 2013 Regional Postgraduate Course Evaluation of Liver Mass Lesions American College of Gastroenterology 2013 Regional Postgraduate Course Lewis R. Roberts, MB ChB, PhD Division of Gastroenterology and Hepatology Mayo Clinic College of

More information

16 April 2010 Resident Teaching Conference. Pancreatitis. W. H. Nealon, M.D., F.A.C.S. J.J. Smith, M.D., D.W.D.

16 April 2010 Resident Teaching Conference. Pancreatitis. W. H. Nealon, M.D., F.A.C.S. J.J. Smith, M.D., D.W.D. 16 April 2010 Resident Teaching Conference Pancreatitis W. H. Nealon, M.D., F.A.C.S. J.J. Smith, M.D., D.W.D. Santorini Wirsung anatomy.med.umich.edu/.../ duodenum_ans.html Bud and ductology Ventral pancreatic

More information

Pancreatic Imaging Mimics: Part 2, Pancreatic Neuroendocrine Tumors and Their Mimics

Pancreatic Imaging Mimics: Part 2, Pancreatic Neuroendocrine Tumors and Their Mimics Integrative Imaging Pictorial Essay Raman et al. Mimics of Pancreatic Neuroendocrine Tumors Integrative Imaging Pictorial Essay CME SM Pancreatic Imaging Mimics Downloaded from www.ajronline.org by 46.3.204.193

More information

Kidney Case 1 SURGICAL PATHOLOGY REPORT

Kidney Case 1 SURGICAL PATHOLOGY REPORT Kidney Case 1 Surgical Pathology Report February 9, 2007 Clinical History: This 45 year old woman was found to have a left renal mass. CT urography with reconstruction revealed a 2 cm medial mass which

More information

Images In Gastroenterology

Images In Gastroenterology Images In Gastroenterology Thong-Ngam D, et al. THAI J GASTROENTEROL 2005 Vol. 6 No. 2 May - Aug. 2005 105 Imaging of Gastrointestinal Stromal Tumors Pornpim Fuangtharnthip, M.D. Narumol Hargroove, M.D.

More information