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Atypical and uncommon CT and MR imaging presentations of pancreatic ductal adenocarcinoma

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Abstract

Pancreatic ductal adenocarcinomas (PDACs) occasionally have atypical and uncommon imaging presentations that can present a diagnostic dilemma and result in false interpretation. This article aimed to illustrate these CT and MR imaging findings, including isoattenuating PDAC, coexisting acute pancreatitis, PDAC with a cystic feature, groove PDAC, diffuse PDAC, hypointensity on diffusion-weighted imaging (DWI), multifocal PDAC, intratumoral calcification, and extrapancreatic invasion with a barely discernable mass. A subset of PDACs with atypical features are occasionally encountered during routine clinical practice. Knowledge of and attention to these atypical and uncommon variable imaging features may allow radiologists to avoid misinterpretation and a delayed diagnosis.

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Data availability

The material analyzed in the current study are available from the corresponding author on reasonable request.

Abbreviations

PDAC:

Pancreatic ductal adenocarcinoma

DWI:

Diffusion weighted imaging

EUS:

Endoscopic ultrasound

H-E:

Hematoxylin–eosin

IPMC:

Intraductal papillary mucinous neoplasms with associated invasive carcinoma of the pancreas

AIP:

Autoimmune pancreatitis

PanNETs:

Pancreatic neuroendocrine tumors

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Authors and Affiliations

  1. Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 Pujian Rd., Pudong, 200127, Shanghai, People’s Republic of China

    Xu Hua Gong, Jian Rong Xu & Li Jun Qian

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  1. Xu Hua Gong
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Material preparation: XHG and LJQ, idea for the article: LJQ. All authors read and approved the final manuscript.

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Correspondence to Li Jun Qian.

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Gong, X.H., Xu, J.R. & Qian, L.J. Atypical and uncommon CT and MR imaging presentations of pancreatic ductal adenocarcinoma. Abdom Radiol 46, 4226–4237 (2021). https://doi.org/10.1007/s00261-021-03089-6

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