JLE

Hépato-Gastro & Oncologie Digestive

MENU

How to investigate pancreatic cysts? Volume 21, issue 5, Mai 2014

Figures


  • Figure 1

  • Figure 2

  • Figure 3

  • Figure 4

  • Figure 5

  • Figure 6

  • Figure 7
Author
Hôpital Beaujon,
service de pancréatologie,
gastroentérologie,
100, boulevard du général Leclerc
92110 Clichy,
France
* Tirés à part

The discovery of cystic pancreatic lesions, and particularly in fortuitous situation, is increasingly common, thanks to advances in conventional imaging performances. The prevalence of pancreatic cysts is estimated at nearly 20% in the general population and increases according to age, especially after 70 years. In the context of recent acute pancreatitis, the most common pancreatic cyst is pseudocyst and represents more than 80% of the cases. Apart from this particular context, the most common pancreatic cysts that may be a diagnostic challenge are serous cystadenoma, mucinous cystadenoma and intraductal papillary mucinous neoplasms (IPMN). More rarely, cystic neuroendocrine tumors, solid pseudopapillary tumor and acinar cystadenoma, a newly described entity, are encountered.

Gastroenterologists have to combine the different types of imaging procedures to make an accurate diagnosis and to propose the adapted treatment and follow up. Some of these lesions are precancerous and the follow up have to be accurate, particularly in cases of IPMN branch ducts. CT scan and MRI (with cholangiowirsungography sequences) are the first line procedures, however endoscopic ultrasound has to be performed rapidly in case of doubt of diagnosis or cancer.