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Adenosquamous carcinoma of pancreas: CT and MR imaging features in eight patients, with pathologic correlations and comparison with adenocarcinoma of pancreas

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Abstract

Purpose

To reveal the CT and MR imaging features of adenosquamous carcinoma of pancreas (ASqC) in eight patients.

Methods

This study was approved by our institutional review board. Eight patients with ASqC were included in this study. Radiologic and pathologic findings were reviewed in each lesion. Additionally, radiologic imaging findings were compared between ASqC and controlled adenocarcinoma groups.

Results

Significant differences between ASqC and adenocarcinoma groups were noted in lesion shape, enhancement pattern on dynamic CT images, the presence or absence of necrosis, and tumor thrombus in the portal vein (PV) system. Compared with adenocarcinoma, ASqC tended to be round-lobulated shape (100% vs. 57.6%), have necrotic portions (100% vs. 39.4%), and have tumor thrombus in the PV system (37.5% vs. 6.1%). Extensive central necrosis was found in six (75%) of ASqC lesions. More lesions in ASqC group (62.5% vs. 12.1%) showed the highest absolute attenuation on pancreatic arterial phase (PAP) or portal venous phase (PVP) images, although the average attenuation values of all ASqC lesions on PAP, PVP, and delayed phase images were almost the same. Five (83.3%) of six resected lesions appeared as nodular type macroscopically. Microscopically, all lesions did not show infiltrating growth pattern, but showed an intermediate growth pattern, and were surrounded incompletely by fibrous tissue.

Conclusions

ASqC tended to be a round-lobulated lesion with extensive central necrosis. Additionally, tumor thrombus in the PV system was often present. These CT and MR imaging features could be a useful clue for diagnosing ASqC.

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Authors and Affiliations

  1. Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, 920-8641, Japan

    Fumihito Toshima, Dai Inoue, Kotaro Yoshida, Norihide Yoneda, Tetsuya Minami, Satoshi Kobayashi, Osamu Matsui & Toshifumi Gabata

  2. Department of Pathology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, 920-8641, Japan

    Hiroko Ikdeda

Authors
  1. Fumihito Toshima
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  2. Dai Inoue
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  3. Kotaro Yoshida
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  4. Norihide Yoneda
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  5. Tetsuya Minami
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  6. Satoshi Kobayashi
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  7. Hiroko Ikdeda
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  8. Osamu Matsui
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  9. Toshifumi Gabata
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Correspondence to Fumihito Toshima.

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Toshima, F., Inoue, D., Yoshida, K. et al. Adenosquamous carcinoma of pancreas: CT and MR imaging features in eight patients, with pathologic correlations and comparison with adenocarcinoma of pancreas. Abdom Radiol 41, 508–520 (2016). https://doi.org/10.1007/s00261-015-0616-4

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  • DOI: https://doi.org/10.1007/s00261-015-0616-4

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