CT Imaging Features and Their Correlation with Pathological Findings of Solid Pseudopapillary Tumor of Pancreas_Journal of Biomedical Engineering

Authors：

ZHENGXingju , TANXianzheng ,  WUBing

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

WUBing, Email: bingwu69@163.com

Keywords：

pancreas neoplasm; solid pseudopapillary tumor; tomography, X-ray computed; pathology

DOI：

10.7507/1001-5515.20140021

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To analyze the CT features of solid pseudopapillary tumor of pancreas (SPTP), and correlation with the pathological findings of the disease so as to improve the diagnostic abilities, the CT images and the clinical manifestations, we retrospectively analyzed the pathological materials of 23 cases with surgery and pathology proved SPTP. In the 23 patients, 21 cases were female (91.3%) and 2 were male (8.7%). The most common symptom was abdominal discomfort with dull pain in 12 patients (52.2%). Others included the pancreatic mass that was detected incidentally during physical examination in 9 patients (39.1%), nausea/vomiting in 2 patients (8.7%). And 1 case of female patients had 2 lesions. In the 24 tumors, 6 cases were located at the head (25.0%), 3 were at neck (12.5%), 8 cases were at body (33.3%), and 7 cases were at tail of pancreas respectively (29.2%). The long-axis diameter ranged from 2.1cm to 20.1cm (mean 6.4cm). 9 tumors were mostly solid component (37.5%), 10 tumors were contained similar proportion of solid and cystic part (41.7%), and mainly cystic components in 5 tumors (20.8%). In 9 of the 23 patients, calcification was found in the tumor (39.1%). In 2 of the 23 patients, bleeding was seen in the mass (8.7%). The dilation of intrahepatic bile duct was found in 1 patient (8.7%). Liver metastasis was showed in one patient (8.7%). On post-contrast CT scan, solid parts demonstrated mild enhancement at the arterial phase. At the portal phase, solid parts were enhanced continuously in all cases, and the enhancement degrees were lower than normal pancreatic tissue. The cystic parts of all lesions showed no enhancement. Pseudo papillary structure, hemorrhage, necrosis, or cystic degeneration were found in all patients by histological study. In a word, SPTP has comparatively characteristic CT imaging features consistent with histological features, when combined with clinical manifestations, could be correctly diagnosed and differentially diagnosed.

Citation： ZHENGXingju, TANXianzheng, WUBing. CT Imaging Features and Their Correlation with Pathological Findings of Solid Pseudopapillary Tumor of Pancreas. Journal of Biomedical Engineering, 2014, 31(1): 107-112. doi: 10.7507/1001-5515.20140021 Copy

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2.	ALLEN P J, D'ANGELICA M, GONEN M, et al. A selective approach to the resection of cystic lesions of the pancreas:results from 539 consecutive patients[J]. Ann Surg,2006,244(4):572-582.
3.	MULKEEN A L, YOO P S, CHA C. Less common neoplasms of the pancreas[J]. World J Gastroenterol,2006,12(20):3180-3185.
4.	温锋, 孙巍, 梁宏元, 等. 胰腺实性假乳头状瘤的影像诊断[J]. 中国临床医学影像杂志, 2011,22(3):195-197.
5.	REDDY S, CAMERON J, SCUDIERE J, et al. Surgical management of solid-pseudopapillary neoplasms of the pancreas (Franz or Hamoudi tumors):a large single-institutional series[J]. J Am Coll Surg 2009,208(5):950-957.
6.	FRANTZ V K. Tumors of the pancreas,in anonymous atlas of tumor pathology.7th ed[M]. Washington DC:Armed Forces Institute of Pathology,1959,32-33.
7.	YAO H Q, LIN H P, ZHANG T, et al. CT findings analysis of solid pseudopapillary tumor of the pancreas[J]. Chinese-German Journal of Clinical Oncology, 2011,10(6):328-332.
8.	KOSMAHL M, SEADA L S, JÄNIG U, et al. Solid-pseudopapillary tumor of the pancreas:Its origin revisited[J]. Virchow Arch, 2000,436(5):473-480.
9.	BUTTE J M, BRENNAN M F, GÖNEN M, et al. Solid pseudopapillary tumors of the pancreas. Clinical features, surgical outcomes, and long-term survival in 45 consecutive patients from a single center[J]. J Gastrointest Surg, 2011,15(2):350-357.
10.	GOH B K, TAN Y M, CHEOW P C,et al. Solid pseudopapillary neoplasms of the pancreas:an updated experience[J]. J Surg Oncol 2007, 95(8):640-644.
11.	LI Z J, ZHANG Z D, LIU X, et al. Solid pseudopapillary tumor of the pancreas:the surgical procedures[J]. Surg Today, 2011,41(1):91-96.
12.	YAO X, JI Y, ZENG M S, et al. Solid pseudopapillary tumor of the pancreas cross-sectional imaging and pathologic correlation[J]. Pancreas, 2010,39(4):486-491.
13.	胡敏霞, 赵心明, 罗巍. 胰腺实性假乳头状瘤的多层螺旋CT表现与病理对照[J]. 中国医学影像技术,2010,26(7):1277-1280.
14.	LEE S E, JANG J Y, HWANG D W, et al. Clinical features and outcome of solid pseudopapillary neoplasm:differences between adults and children[J]. Arch Surg, 2008,143(12):1218-1221.
15.	CASADEI R, SANTYNI D, CALCULLI L, et al. Pancreas solid-cystic papaillary tumor:clinical features, imaging findings and operative management[J]. JOP, 2006,7(1):137-144.

1. ADAMS A L, SIEGAL G P, JHALA N C. Solid pseudopapillary tumor of the pancreas. A review of salient clinical and pathologic features[J]. Adv Anat Pathol,2008,15(1):39-45.
2. ALLEN P J, D'ANGELICA M, GONEN M, et al. A selective approach to the resection of cystic lesions of the pancreas:results from 539 consecutive patients[J]. Ann Surg,2006,244(4):572-582.
3. MULKEEN A L, YOO P S, CHA C. Less common neoplasms of the pancreas[J]. World J Gastroenterol,2006,12(20):3180-3185.
4. 温锋, 孙巍, 梁宏元, 等. 胰腺实性假乳头状瘤的影像诊断[J]. 中国临床医学影像杂志, 2011,22(3):195-197.
5. REDDY S, CAMERON J, SCUDIERE J, et al. Surgical management of solid-pseudopapillary neoplasms of the pancreas (Franz or Hamoudi tumors):a large single-institutional series[J]. J Am Coll Surg 2009,208(5):950-957.
6. FRANTZ V K. Tumors of the pancreas,in anonymous atlas of tumor pathology.7th ed[M]. Washington DC:Armed Forces Institute of Pathology,1959,32-33.
7. YAO H Q, LIN H P, ZHANG T, et al. CT findings analysis of solid pseudopapillary tumor of the pancreas[J]. Chinese-German Journal of Clinical Oncology, 2011,10(6):328-332.
8. KOSMAHL M, SEADA L S, JÄNIG U, et al. Solid-pseudopapillary tumor of the pancreas:Its origin revisited[J]. Virchow Arch, 2000,436(5):473-480.
9. BUTTE J M, BRENNAN M F, GÖNEN M, et al. Solid pseudopapillary tumors of the pancreas. Clinical features, surgical outcomes, and long-term survival in 45 consecutive patients from a single center[J]. J Gastrointest Surg, 2011,15(2):350-357.
10. GOH B K, TAN Y M, CHEOW P C,et al. Solid pseudopapillary neoplasms of the pancreas:an updated experience[J]. J Surg Oncol 2007, 95(8):640-644.
11. LI Z J, ZHANG Z D, LIU X, et al. Solid pseudopapillary tumor of the pancreas:the surgical procedures[J]. Surg Today, 2011,41(1):91-96.
12. YAO X, JI Y, ZENG M S, et al. Solid pseudopapillary tumor of the pancreas cross-sectional imaging and pathologic correlation[J]. Pancreas, 2010,39(4):486-491.
13. 胡敏霞, 赵心明, 罗巍. 胰腺实性假乳头状瘤的多层螺旋CT表现与病理对照[J]. 中国医学影像技术,2010,26(7):1277-1280.
14. LEE S E, JANG J Y, HWANG D W, et al. Clinical features and outcome of solid pseudopapillary neoplasm:differences between adults and children[J]. Arch Surg, 2008,143(12):1218-1221.
15. CASADEI R, SANTYNI D, CALCULLI L, et al. Pancreas solid-cystic papaillary tumor:clinical features, imaging findings and operative management[J]. JOP, 2006,7(1):137-144.

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