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Pancreatitis and PDAC: association and differentiation

  • Sherif B. ElsherifEmail author
  • Mayur Virarkar
  • Sanaz Javadi
  • Juan J. Ibarra-Rovira
  • Eric P. Tamm
  • Priya R. Bhosale
Special Section: Pancreatitis
  • 11 Downloads

Abstract

The discrimination of mass-forming chronic pancreatitis (MFCP) from pancreatic ductal adenocarcinoma (PDAC) is a central diagnostic dilemma. It is important to differentiate these entities since they have markedly different prognoses and management. Importantly, the appearance of these two entities significantly overlaps on a variety of imaging modalities. However, there are imaging features that may be suggestive of one entity more than the other. MFCP and PDAC may show different enhancement patterns on perfusion computed tomography (CT) and/or dynamic contrast-enhanced MRI (DCE-MRI). The duct-penetrating sign on magnetic resonance cholangiopancreatography (MRCP) is more often associated with MFCP, whereas abrupt cutoff with upstream dilatation of the main pancreatic duct and the double-duct sign (obstruction/cutoff of both the common bile duct and pancreatic duct) are more often associated with PDAC. Nevertheless, tissue sampling is the most reliable method to differentiate between these entities and is currently generally necessary for management.

Keywords

Pancreatitis Pancreatic cancer Mass-forming chronic pancreatitis Pancreatic ductal adenocarcinoma MRCP 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. 1.The Department of Diagnostic RadiologyThe University of Texas M. D. Anderson Cancer CenterHoustonUSA
  2. 2.The Department of Internal MedicineWeiss Memorial Hospital, Affiliate of the University of Illinois at ChicagoChicagoUSA

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