CT imaging features of acinar cell carcinoma and its hepatic metastases
P Bhosale1, A Balachandran, H Wang
1Department of Diagnostic Radiology, UT MD Anderson Cancer Center, 1400 Pressler Street, Unit 1473, Houston, TX, 77030, USA, priya.bhosale@mdanderson.org.
Objective:
To evaluate and describe the computed tomography features of pure acinar cell carcinoma (ACC) and its liver metastases.
Methods:
Thirty patients were evaluated. Two radiologists evaluated imaging findings for each tumor for size, location, internal density, enhancement, tumor calcifications, pancreatic, and common biliary ductal obstructions and metastases.
Results:
70 % were male. Fourteen tumors were located in the pancreatic head, 14 in the tail, one in the neck, and one in the uncinate process. Abdominal pain was the most common presenting symptom (93 %), 20 % had pancreatitis and 17 % had obstructive jaundice. The average tumor size was 7 cm, 97 % of tumors were solid, well circumscribed (73 %); isodense to normal pancreatic parenchyma (40 %) on the non-contrast study, hypodense on the arterial (47 %), and hypodense on the portal venous (37 %) phase. 30 % patients had pancreatic ductal dilation, 10 % had pancreatic ductal ingrowth, 6 % had calcifications, and 20 % had central necrosis, and 31 % (5/16) showed biliary ductal dilation. At presentation, 50 % had metastatic adenopathy and 40 % patients had liver metastases, which typically were well circumscribed, hypoattenuating to the hepatic parenchyma on all the phases of contrast enhancement and had a lobulated margin.
Conclusion:
ACCs of the pancreas often present as large, well circumscribed, solid masses commonly in males. Despite their large size, they may not cause CBD obstruction.
