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Heterotopic pancreas of the jejunum: associations between CT and pathology features

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Abstract

Purpose

To investigate the computed tomography (CT) features of heterotopic pancreas of the jejunum (HPJ) and to assess their associations with HPJ pathology features.

Methods

In this retrospective series analysis, two radiologists reviewed the CT images of 17 patients with surgically proven HPJ in order to determine in consensus the location, long diameter, margin, shape, contour, and growth pattern of the lesions, the presence of a duct-like structure, the lesion enhancement patterns, including the homogeneity, and the degree of contrast enhancement compared with that of the main pancreas. The pathology features of the surgical specimens were reviewed and their associations with the CT features were assessed.

Results

On CT, the HPJs typically appeared as a small (<3 cm), well-defined, ovoid or flat-shaped mass in the proximal jejunum with multiple and tiny lobulations. The growth pattern varied and the duct-like structure was rarely visible. The HPJs mostly appeared to be homogeneous and exhibited hyper- or isoattenuation compared to the main pancreas in the arterial and portal phases. However, these enhancement patterns varied slightly depending on the microscopic composition of the lesions (i.e., acinar vs. ductal predominance). Most HPJs comprised histologically of large acini, some ducts, and small islet cells, and had ductal communication with the jejunum.

Conclusions

HPJs typically manifested as small, well-defined, ovoid or flat-shaped, homogeneous, and well-enhancing masses with a microlobulated contour in the proximal jejunum on CT, and their enhancement patterns associated with their microscopic composition. The pathology features of HPJs generally mimic those of the normal pancreas.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, Korea

    Dong Wook Kim, Jin Hee Kim, Seong Ho Park, Jong Seok Lee & Hyun Kwon Ha

  2. Department of Diagnostic Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro, 43-gil, Songpa-Gu, Seoul, 138-736, Korea

    Seung-Mo Hong & Misung Kim

Authors
  1. Dong Wook Kim
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  2. Jin Hee Kim
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  3. Seong Ho Park
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  4. Jong Seok Lee
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  5. Seung-Mo Hong
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  6. Misung Kim
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  7. Hyun Kwon Ha
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Correspondence to Jin Hee Kim.

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Kim, D.W., Kim, J.H., Park, S.H. et al. Heterotopic pancreas of the jejunum: associations between CT and pathology features. Abdom Imaging 40, 38–45 (2015). https://doi.org/10.1007/s00261-014-0177-y

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  • DOI: https://doi.org/10.1007/s00261-014-0177-y

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