Differential Diagnosis and Imaging Examination of Pancreatic Cancers




The CT scan can help detect vascular invasion and metastases.



遠位胆管癌  distal cholangiocarcinoma;

確定診断  definitive diagnosis;

間質線維化反応  desmoplastic reaction;

鑑別診断  differential diagnosis;

偽陰性の  false-negative;

偽嚢胞  pseudocyst;

血管浸潤  vascular invasion;

膵炎  pancreatitis;

膵管癌  pancreatic ductal cancer;

切除可能性  resectability;

超音波内視鏡検査  endoscopic ultrasonography (EUS);

転移  metastasis;

微小針吸引法  fine-needle aspiration;

腹腔鏡  laparoscopy;

膨大部癌  ampullary cancer;

マルチスライス式コンピュータ断層撮影  multidetector computer tomography



A differential diagnosis should be performed to distinguish a pancreatic cancer from acute or chronic pancreatitis.



If patients contract ampullary cancer and distal cholangiocarcinomas, obstructive bile ducts and jaundice occur.



Cystic pancreatic neoplasms cannot be easily differentiated from non-neoplastic pancreatic pseudocysts by imaging studies.  If the patient has a cystic neoplasm, patients with isolated cystic lesions and have no experience of acute or chronic pancreatitis are likely to contract a cystic neoplasm.





credit:  Pancreatic cancer, onhelth.com


Imaging Studies


If patients are suspected to contract pancreatic cancers, they are recommended to have a multidetector CT scan that photographs multiple thin cuts of the pancreas with X rays and creates 3-D images of pancreas with a computer.



The CT scan can help detect vascular invasion and metastases.  It has approximately 90% accuracy of evaluation of resectability of pancreatic cancers.



Endoscopic ultrasonography can be used for patients with pancreatic cancers that have not been revealed by CT scan.



If a preoperative biopsy is required to determine if pancreases are cancerous, a fine-needle aspiration under endoscopic guidance should be used so as to prevent cancer cells from spreading to neighboring tissues.  When patients with pancreatic cancers are resectable, they can directly undergo surgery.


The desmoplastic reaction that occurs in pancreatic ductal adenocarcinoma may cause false-negative result to occur in the biopsy.



Laparoscopy may reveal occult metastases in the peritoneum or the surface of the liver.



If CT scan results indicate that the pancreatic cancers are unresectable because of local extension or the presence of metastases, the patients need to have a fine-needle aspiration biopsy of the primary or metastatic site to make a definitive diagnosis.