Radiol Clin N Am 40 (2002) 1243-1262.
Hammond N, Miller FH, Sica GT, Gore RM.
With the increasing use of noninvasive imaging modalities, including CT, sonography, and MRI, pancreatic cystic lesions are being detected more frequently and are often incidental findings. In part, this increased rate of detection is secondary to technical advances in ultrasound, helical CT, and MR scanners. It is often the role of the radiologist to guide clinicians who are managing these lesions. The most important distinction is the differentiation between pancreatic pseudocysts and cystic neoplasms of the pancreas. Cystic neoplasms represent 10% to 15% of pancreatic cysts, with the remainder being pseudocysts [1,2]. When there is a history of clinical and imaging features of pancreatitis, the diagnosis of pseudocysts is much more likely. In patients without a history of pancreatitis, it is incumbent on the radiologist to suggest other etiologies. The differential is broad and outlined in Table 1.
The spectrum of cystic neoplasms of the pancreas encompasses a wide range of histologies from benign to malignant. The majority of cystic masses of the pancreas, excluding pseudocysts, will be either muci-nous cystic neoplasms or microcystic adenomas. Although definitive diagnosis is often not possible radiographically, the goal of this article is to discuss the imaging findings of the other types of pancreatic cystic lesions.