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Pancreatic Carcinoma

Faye C Laing, MD

March 28, 1994

Presentation

An elderly man presented with recent onset of jaundice.

Imaging Findings

Transverse Ultrasound
Sagittal Ultrasound

Transverse and sagittal scans coned down over the pancreas reveal an irregularly dilated, tubular structure (transverse with arrow) (sagittal with arrow) within the substance of the pancreas. There is no definite pancreatic mass, and pancreatic calcification is not visible. The surrounding anatomy is unremarkable.

Diagnosis

Pancreatic carcinoma

Discussion

The intrapancreatic, tubular shaped, hypoechoic structure is a dilated pancreatic duct. Normally, its diameter is less than 2 mm, and in a patient with a recent history of jaundice, a neoplasm should be suspected. Dilatation of the pancreatic duct can occur with neoplasm as well as pancreatitis (chronic or acute). Although the appearance of the duct may be similar in these conditions, most patients with chronic pancreatitis have glandular calcifications, while patients with acute pancreatitis have an enlarged, sonolucent (edematous) gland and peripancreatic effusions.

Other images obtained during this examination revealed extrahepatic bile duct dilatation and a small mass in the head of the pancreas, which was subsequently proven to be pancreatic carcinoma.

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