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- Title
Imaging and clinical features of xanthogranulomatous pancreatitis: an analysis of 10 cases at a single institution.
- Authors
Kwon, Ji Hye; Kim, Jin Hee; Kim, So Yeon; Byun, Jae Ho; Kim, Hyoung Jung; Lee, Moon-Gyu; Lee, Seung Soo; Hong, Seung-Mo
- Abstract
Purpose: The purpose of the study was to investigate the imaging and clinical features of xanthogranulomatous pancreatitis (XGP).Methods: This retrospective series study included 10 patients with pathology-proven XGP. Two radiologists reviewed the computed tomography (CT) and magnetic resonance imaging (MRI) in consensus to determine the morphological features of XGP. The lesion enhancement pattern on dynamic contrast-enhanced scans and the MR signal intensity were also evaluated. Clinical data including symptoms, underlying pancreatic disease, and laboratory findings were reviewed.Results: Two XGP cases were of a solid type; six were of cystic type, and two were mixed type. XGP usually showed a lobulated contour (90%) and heterogeneous enhancement (100%), with lesion size varying from 2 to 11 cm. Perilesional infiltration was common (90%), but pancreatic duct dilatation was less frequent (30%). Cystic type XGP mostly had an irregular thick wall (83%). On dynamic contrast-enhanced CT/MRI, XGP enhanced progressively from arterial to portal or delayed phases. Lesions appeared hypointense on T1-weighted images (89%) and hyperintense on T2-weighted images (100%). All lesions appeared hyperintense on diffusion-weighted images, with the majority (78%) showing diffusion restriction on apparent diffusion coefficient maps. The patients often had abdominal pain (80%) and underlying pancreatic disease (80%), but mostly had normal or clinically insignificant laboratory findings.Conclusions: XGP typically manifests as a clinically silent lobulated heterogeneous mass, with a progressive enhancement pattern and/or irregular thick wall, and diffusion restriction on CT/MRI. Awareness of the imaging and clinical features of XGP may help differentiate it from pancreatic neoplasms, thereby reducing unnecessary surgery.
- Subjects
PANCREATITIS; COMPUTED tomography; MAGNETIC resonance imaging; PATHOLOGICAL physiology; CLINICAL medicine
- Publication
Abdominal Radiology, 2018, Vol 43, Issue 12, p3349
- ISSN
2366-004X
- Publication type
Article
- DOI
10.1007/s00261-018-1630-0