Answer for BIR CoW 30 Sep 2018
Mucinous cystic neoplasm of pancreas with cystic liver mets
Findings
USG ABDOMEN:6*4.3 cm heteroechoeic lesion noted in body and tail of pancreas.Multiple hypoechoeic lesions noted in both lobes of the liver. CT findings:Well defined ovoid hypodense fluid density lesion in body and tail of pancreas.No surrounding fat stranding.No central scar.No calcification.No communication with pancreatic duct Liver shows multiple cystic lesions with peripheral arterial enhancement Ct guided biopsy was taken and the histopathology report – clusters of atypical cells with mucinous cytoplasm and pleomorphic hyperchromatic nuclei.stroma shows myxoid change. P/O mucinous cystic neoplasm of pancreas.
Discussion
44% to 49% of pancreatic cystic lesions predominantly in women, with a mean age of 47 years (Mother lesion) The majority are solitary and multilocular with a few large compartments (between 2 and 6 cm) asymptomatic (75%) Location in the tail and body of the pancreas (95%). The majority have a smooth contour, The mean size is greater than 5 cm (range, 3 to 20 cm), they have a thick fibrotic wall that can calcify. They do not communicate with the pancreatic duct, but they can cause ductal obstruction. Peripheral eggshell or septal calcifications on CT are specific for mucinous cystic lesions and are predictive of malignancy
Findings
USG ABDOMEN:6*4.3 cm heteroechoeic lesion noted in body and tail of pancreas.Multiple hypoechoeic lesions noted in both lobes of the liver. CT findings:Well defined ovoid hypodense fluid density lesion in body and tail of pancreas.No surrounding fat stranding.No central scar.No calcification.No communication with pancreatic duct Liver shows multiple cystic lesions with peripheral arterial enhancement Ct guided biopsy was taken and the histopathology report – clusters of atypical cells with mucinous cytoplasm and pleomorphic hyperchromatic nuclei.stroma shows myxoid change. P/O mucinous cystic neoplasm of pancreas.
Discussion
44% to 49% of pancreatic cystic lesions predominantly in women, with a mean age of 47 years (Mother lesion) The majority are solitary and multilocular with a few large compartments (between 2 and 6 cm) asymptomatic (75%) Location in the tail and body of the pancreas (95%). The majority have a smooth contour, The mean size is greater than 5 cm (range, 3 to 20 cm), they have a thick fibrotic wall that can calcify. They do not communicate with the pancreatic duct, but they can cause ductal obstruction. Peripheral eggshell or septal calcifications on CT are specific for mucinous cystic lesions and are predictive of malignancy
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
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Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!