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CT and MRI manifestations of pancreatitis misdiagnosed as pancreatic cancer SU Tao*,WANG Jian,JIN Han-tao,et al. *Department of Emergency,Center Hospital of Xuhui District,Shanghai 200031,China
Corresponding author : WANG Jian ,E-mail:wangjian_su@yahoo.com.cn
Abstract Objective To research the key points in differential diagnosis of pancreatitis and pancreatic cancer. Methods The imaging data of 22 cases of pancreatitis misdiagnosed as pancreatic cancer between 2001 and 2010 at Changzheng Hospital Affiliated to the Second Military Medical University were analyzed retrospectively. Results Manifestations of pancreatitis misdiagnosed as localized pancreatic cancer were pseudotumorous pancreatitis of pancreatic head or pancreatic body;pancreatic necrosis and pseudocyst;inhomogeneous lipidosis;retentive extension of pancreatic duct due to pancreas divisum and accumulation of blood in pancreatic duct due to pancreas divisum. Misdiagnosed as disseminated pancreatic cancer were disseminated enlargement of pancreas with inhomogeneous density, lesser blood supply lesion and pancreatitis without effusion. Misdiagnosed as metastases outside pancreas were parapancreatic pseudocysts or inflammatory mass misdiagnosed as metastatic lymph nodes. Accessory lesions of superior mesenteric vein and splenic vein misdiagnosed as vascular invasions. Conclusion Diagnosis of atypical pancreatic cancer should be based on a comprehensive knowledge of medical history and weekly follow-ups so as to exclude the possibility of atypical pancreatitis. As for patients who have both pancreatitis and pancreatic cancer,treatments of pancreatitis with therapeutic values should always be emphasized regardless of the pancreatic cancer.
pancreatitis / pancreatic cancer / computed tomography / magnetic resonance imaging
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