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Pancreatic and Peripancreatic Diseases Mimicking Primary Pancreatic Neoplasia¹

¹ From the Department of Radiology, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, BL-428 CHS, Box 951721, UCLA Medical Center, Los Angeles, CA 90095-1721. Presented as an education exhibit at the 2003 RSNA Annual Meeting. Received August 26, 2004; revision requested September 23 and received November 19; accepted November 23. All authors have no financial relationships to disclose. Address correspondence to S.S.R. (e-mail: sraman{at}mednet.ucla.edu).

A variety of anatomic variants and pathologic conditions in and around the pancreas may simulate primary pancreatic neoplasia at routine abdominal cross-sectional imaging. An ambiguous lesion whose appearance suggests a pancreatic origin requires a broad differential diagnosis that can subsequently be narrowed on the basis of both clinical history and features at optimal computed tomography (CT) and magnetic resonance (MR) imaging. Pancreas-specific multidetector CT and MR imaging techniques with thin collimation, multiplanar and multiphasic scans, and newly introduced curved planar reformation may help avoid potential diagnostic pitfalls. These techniques can help identify and characterize a mass in multiple viewing planes, thereby helping distinguish a true pancreatic neoplasm from peripancreatic adenopathy or from a tumor of the adjacent duodenum or small bowel. They can also help determine the cause of a tumor. It is important that the radiologist be familiar with the wide spectrum of anatomic variants and disease entities that can mimic primary pancreatic neoplasia in order to initiate the appropriate lesion-specific work-up and treatment and avoid unnecessary tests or procedures, including surgery.

© RSNA, 2005

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