Classification and Background of Cystic Lesion in the Pancreas Kunio Takagi 1 , Kazuhiko Ohhashi 1 , Takao Takekoshi 2 1Department of surgery, Cancer Institute Hospital 2Department of Internal Medicine, Cancer Institute Hospital pp.711-725
Published Date 1986/7/25
DOI https://doi.org/10.11477/mf.1403110333
  • Abstract
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 Number of cystic lesion in the pancreas is increasing because of recent development of image diagnostic technique.

 Based on 27 cases resected in Cancer Institute Hospital for these 8 years from 1978 to 1985, classification of cystic lesion in the pancreas is proposed as followings, benign lesion, cystadenoma, cystadenocarcinoma, mucous-producing cancer and secondary cystic lesion caused by cancer.

 Benign lesion includes 4 cases of pseudocyst and 4 cases of ductogenic cyst.

 Cystadenoma involves two classical types, microcystic type and megacystic type, and the original type, ductectatic type which have connection with main pancreatic duct. Ductectatic type located mainly in the uncinate process of the pancreas head and showed characteristic patterns of panereatogram lake as tree root appearance, small diameter from 2 to 4 cm and mucin production.

 Cystadenocarcinoma and mucous-producing cancer have something in common with papillary adenocarcinoma and mucin production. Mucous-producing cancer developer in the main pancreatic duct and causes marked dilatation of main pancreatic duct and widening of the orifice of major papilla. Cystadenocarcinoma shows round shape and has no connection with main pancreatic duct. Therefore, clinical discrimination of both became possible.

 Cystic change caused by main pancreatic duct obstruction due to cancer is often observed. When cystic change and cancer locate closely, cancerous lesion may be concealed by noticeable cystic change.

 Here we stress the morphological analysis of cystic lesion and meticulous diagnosis of presence or absence of cancer and inflammatory change, when cystic lesion of the pancreas is detected. US and CT can reveal morphological appearance of cystic lesion, but hardly demonstrates corelation between main pancreatic duct and cystic lesion.

 It is important for the diagnosis of cystic lesion and background to know the connection between cystic lesion and main pancreatic duct as well as pancreatogram close to the lesion.

Copyright © 1986, Igaku-Shoin Ltd. All rights reserved.


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