81 Pancreatic Masses on the Ultrasound

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig GI 81-1 Carcinoma of the pancreas. Longitudinal sonogram demonstrates an irregular mass (M) with a semisolid pattern of intrinsic echoes. There is associated dilatation of the intrahepatic bile ducts (arrows). (A, aorta.)162

• Fig GI 81-2 Pancreatic carcinoma with liver metastases. Transverse sonogram shows an enlarged liver containing multiple metastatic lesions (arrowheads).95

• Fig GI 81-3 Pancreatic carcinoma with lymph node metastases. Diffuse enlargement of the pancreas (P) with enlarged hypoechoic paravascular lymph nodes (LN) that obscure the aorta and inferior vena cava.95

Fig GI 81-4 Islet cell tumor. This cystic mass in the head of the pancreas shows acoustic enhancement without evidence of debris.163

• Fig GI 81-5 Mucinous cystic neoplasm. Multiloculated cystic mass with echogenic internal septa within the tail of the pancreas. Echogenic foci with shadowing that correspond to calcifications are noted along the septa (arrow). Note the low-level internal echoes.164

• Fig GI 81-6 Serous cystadenoma. Sonogram shows a mass of low echogenicity due to the interfaces between the tiny cysts. Note the increased through transmission posterior to the mass.165

• Fig GI 81-7 Pancreatic pseudocyst. Longitudinal sonogram of the right upper quadrant demonstrates an irregularly marginated pseudocyst (PC) with acoustic shadowing (arrow). (L, liver.)

Fig GI 81-8 Pancreatic pseudocyst. An erect sonogram demonstrates a fluid-debris level (arrow) in the pseudocyst. 1(L, left kidney.)

• Fig GI 81-9 Pancreatic phlegmon. Transverse sonogram shows a hypoechoic mass (M) in the peripancreatic region.95

• Fig GI 81-10 Cystic fibrosis. Transverse sonogram at the level of the pancreatic head (P) shows complete fibrofatty replacement of the gland with absence of normal tissue. Note the multiple cysts (*) of different sizes adjacent to the liver (L) and stomach (St).166