scholarly journals Magnetic Resonance Cholangiopancreatography with Secretin Stimulation in the Diagnosis of Intraductal Papillary Mucinous Neoplasm: A Paradigmatic Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Elsa Iannicelli ◽  
Francesco Carbonetti ◽  
Marco Di Pietropaolo ◽  
Giulia Francesca Federici ◽  
Gabriele Capurso ◽  
...  
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Intraductal Papillary Mucinous Neoplasm ◽  
Cystic Lesion ◽  
Correct Diagnosis ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Ductal System ◽  
Mucinous Neoplasm ◽  
Mucinous Neoplasms ◽  
Secretin Stimulation

Context.One of the characteristic findings of intraductal papillary mucinous neoplasms (IPMN) is the presence of a direct communication between the lesion and the ductal pancreatic system and when magnetic resonance cholangiopancreatography (MRCP) shows uncertain findings, it is useful to perform a MRCP after secretin stimulation (MRCP-S) which provides a better visualization of the ductal system.Case Report.We present a case of 51-year-old man in whom, during a CT follow-up for a renal tumour, was found a cystic lesion of the pancreas. To better evaluate the lesion and its suspected communication with the pancreatic system, MR with gadolinium and MRCP and MRCP-S were performed. With the MRCP and MRI it was not possible to identify a clear communication between the cystic lesion and the ductal system. MRCP-S showed an increase in signal intensity of the lesion and its communication with the ductal system, allowing us to classify the cystic lesion as a main duct in intraductal papillary mucinous neoplasm. The patient underwent a surgical duodenal pancreatectomy. The histological result of the specimen confirmed the diagnosis of adenocarcinoma IPMN.Conclusion.In this case MRCP-S has allowed a clearer identification of the cystic lesion allowing a correct diagnosis and treatment.

scholarly journals Intrahepatic Biliary Intraductal Papillary Mucinous Neoplasm With Intermittent Jaundice: Case Report

2017 ◽  
Author(s):  
Omer Cennet ◽  
Ahmet Bulent Dogrul ◽  
Mehmet Bulent Tırnaksz ◽  
Halit Uner ◽  
Aytekin Akyol ◽  
...  
Keyword(s):  
Case Report ◽  
Intraductal Papillary Mucinous Neoplasm ◽  
Invasive Carcinoma ◽  
Malignant Potential ◽  
Clinical Entity ◽  
Intraductal Papillary Mucinous Neoplasms ◽  
Ductal System ◽  
Mucinous Neoplasm ◽  
Mucinous Neoplasms

Abstract Intraductal papillary mucinous neoplasms (IPMNs) represent a relatively new clinical entity. IPMNs have malignant potential which exhibit a broad histological spectrum, ranging from adenoma to invasive carcinoma. Although IPMNs are commonly seen within pancreas, they may develop anywhere within the biliary ductal system and produce mucin which may cause intermittent jaundice. This report details the case of 50 year-old woman presenting with intermittent jaundice who was diagnosed as hepatic IPMN.

scholarly journals A Serous Cystic Neoplasm of the Pancreas Coexisting with High-Grade Pancreatic Intraepithelial Neoplasia Mimicking an Intraepithelial Papillary Mucinous Neoplasm: A Case Report

2017 ◽  
Vol 10 (1) ◽  
pp. 143-150 ◽  
Author(s):  
Aya Kawanishi ◽  
Kenichi Hirabayashi ◽  
Hirotaka Kono ◽  
Yumi Takanashi ◽  
Atsuko Hadano ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Pancreatic Duct ◽  
Intraductal Papillary Mucinous Neoplasm ◽  
Main Pancreatic Duct ◽  
Cystic Lesion ◽  
Cystic Neoplasm ◽  
Pancreatic Ducts ◽  
High Grade ◽  
Mucinous Neoplasm ◽  
Serous Cystic Neoplasm

Serous cystic neoplasms of the pancreas are rare exocrine pancreatic neoplasms, most of which are benign and do not communicate with the pancreatic duct. Pancreatic intraepithelial neoplasm (PanIN) is considered a precursor of ductal adenocarcinoma that is microscopically recognized in pancreatic ducts. A 67-year-old Japanese woman presented with a 10-mm multilocular cystic lesion at the pancreatic body. Magnetic resonance pancreatography showed stenosis of the main pancreatic duct at the pancreatic body and dilatation of the distal side of the main pancreatic duct. Furthermore, communication between the cystic lesion and the main pancreatic duct was suspected based on magnetic resonance pancreatography findings. Distal pancreatectomy was performed under the preoperative diagnosis of intraductal papillary mucinous neoplasm. Histologically, the cystic lesion was lined with a non-atypical cuboidal or flat epithelium with clear cytoplasm and was thus diagnosed as a serous cystic neoplasm. High-grade PanIN lesions with stromal fibrosis were observed at the main and branch pancreatic ducts. Histological examination revealed no communication between the serous cystic neoplasm and the pancreatic ducts. Immunohistochemically, the epithelium of the serous cystic neoplasm showed positive anti-von Hippel-Lindau antibody staining, whereas the epithelium of the PanIN showed negative staining. A serous cystic neoplasm coexisting with another pancreatic neoplasm is rare. When dilatation of the main or branch pancreatic ducts coexists with a serous cystic neoplasm, as in this case, the lesion clinically mimics an intraductal papillary mucinous neoplasm.

scholarly journals An incidental case of biliary fascioliasis with subtle clinical findings: US and MRCP findings

2013 ◽  
Vol 47 (2) ◽  
pp. 125-127
Author(s):  
Hakan Önder ◽  
Faysal Ekici ◽  
Emin Adin ◽  
Suzan Kuday ◽  
Hatice Gümüş ◽  
...  
Keyword(s):  
Case Report ◽  
Bile Duct ◽  
Magnetic Resonance ◽  
Biliary Obstruction ◽  
Fasciola Hepatica ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Clinical Findings ◽  
Imaging Studies ◽  
Laboratory Findings ◽  
Acoustic Shadow

Background. Fascioliasis is a disease caused by the trematode Fasciola hepatica. Cholangitis is a common clinical manifestation. Although fascioliasis may show various radiological and clinical features, cases without biliary dilatation are rare. Case report. We present unique ultrasound (US) and magnetic resonance cholangiopancreatography (MRCP) findings of a biliary fascioliasis case which doesn’t have biliary obstruction or cholestasis. Radiologically, curvilinear parasites compatible with juvenile and mature Fasciola hepatica within the gallbladder and common bile duct were found. The parasites appear as bright echogenic structures with no acoustic shadow on US and hypo-intense curvilinear lesions on T2 weighted MRCP images. Conclusions. Imaging studies may significantly contribute to the diagnosis of patients with subtle clinical and laboratory findings, particularly in endemic regions.

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