open access

Vol 7, No 2 (2011)
REVIEW ARTICLES
Published online: 2011-06-22
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Enlarged pancreatic head and other ambiguous findings on pancreatic imaging — how to rule out malignancy?

Marcin Polkowski, Jakub Pałucki
Onkol. Prak. Klin 2011;7(2):66-72.

open access

Vol 7, No 2 (2011)
REVIEW ARTICLES
Published online: 2011-06-22

Abstract

The problem of ambiguous findings on pancreatic imaging is increasingly important in clinical practice and closely related to the huge number of imaging tests being performed in everyday clinical practice. The most common ambiguous finding is a focal or diffuse enlargement (fullness, prominence) of the pancreas without a discrete mass. Although the enlargement represents normal pancreas or benign pancreatic disease in most cases, there is still a considerable risk of malignancy. Results from four retrospective studies conducted in the United States indicate that among patients who underwent endoscopic ultrasonography (EUS) to clarify ambiguous findings on computed tomography or magnetic resonance imaging, 13.5% had pancreatic malignancy, 38% had benign pancreatic disease, and the remaining 48.5% had normal pancreas. These results indicate that ambiguous findings on pancreatic imaging cannot be ignored and need to be clarified. The very high negative predictive value of EUS in patients with a suspicion of pancreatic cancer and the capability to perform EUS-guided fine needle aspiration from focal lesions, makes EUS the perfect tool in such cases. However, a prospective study on this topic is badly needed because all of the available data are from retrospective studies.
Onkol. Prak. Klin. 2011; 7, 2: 66–72

Abstract

The problem of ambiguous findings on pancreatic imaging is increasingly important in clinical practice and closely related to the huge number of imaging tests being performed in everyday clinical practice. The most common ambiguous finding is a focal or diffuse enlargement (fullness, prominence) of the pancreas without a discrete mass. Although the enlargement represents normal pancreas or benign pancreatic disease in most cases, there is still a considerable risk of malignancy. Results from four retrospective studies conducted in the United States indicate that among patients who underwent endoscopic ultrasonography (EUS) to clarify ambiguous findings on computed tomography or magnetic resonance imaging, 13.5% had pancreatic malignancy, 38% had benign pancreatic disease, and the remaining 48.5% had normal pancreas. These results indicate that ambiguous findings on pancreatic imaging cannot be ignored and need to be clarified. The very high negative predictive value of EUS in patients with a suspicion of pancreatic cancer and the capability to perform EUS-guided fine needle aspiration from focal lesions, makes EUS the perfect tool in such cases. However, a prospective study on this topic is badly needed because all of the available data are from retrospective studies.
Onkol. Prak. Klin. 2011; 7, 2: 66–72
Get Citation

Keywords

pancreatic cancer; chronic pancreatitis; pancreatic imaging; computed tomography; endoscopic ultrasonography

About this article
Title

Enlarged pancreatic head and other ambiguous findings on pancreatic imaging — how to rule out malignancy?

Journal

Oncology in Clinical Practice

Issue

Vol 7, No 2 (2011)

Pages

66-72

Published online

2011-06-22

Bibliographic record

Onkol. Prak. Klin 2011;7(2):66-72.

Keywords

pancreatic cancer
chronic pancreatitis
pancreatic imaging
computed tomography
endoscopic ultrasonography

Authors

Marcin Polkowski
Jakub Pałucki

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