Based on the histological characteristics of the mass, pancreatic mass can be generally categorized into solid pancreatic masses and pancreatic cysts described as fluid-filled sacs that form in the pancreas. Solid pancreatic masses without evidence of underlying pancreatic disease are usually identified as incidental lesions on abdominal imaging performed to evaluate nonspecific abdominal pain or for other indications. Most of these lesions are not related to the symptoms that led to the imaging. Both solid pancreatic masses and pancreatic cysts are usually discovered by ultrasonography or computerized tomography (CT scan).
Pancreatic solid masses: If solid mass is detected in the pancreas, differential diagnosis is further required to determine whether it is benign (non-cancerous) or cancerous tumor. Detected masses could be diagnosed with a wide range of pancreatic diseases, extending from pancreatic mass lesion caused by pancreatitis (inflammation in the pancreas), pancreatic neuroendocrine tumor (PNET –a group of endocrine tumors arising in the pancreas), intrapancreatic accessory spleen (a benign condition in which a small nodule of splenic tissue is found in the pancreas) to pancreatic cancer.
Pancreatic cysts: The characteristics of pancreatic cysts can be used to make a primary diagnosis. However, additional investigations e.g. endoscopic ultrasound (EUS), magnetic resonance imaging (MRI) or magnetic resonance cholangiopancreatography (MRCP) might be considered to obtain confirmatory diagnosis. In some cases, pancreatic cysts can be benign neoplasm which is not associated with cancer, such as serous cystadenoma (SCA) and pancreatic pseudocyst. Nevertheless, certain types of pancreatic cyst might tend to progress to cancerous conditions e.g. intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasms (MCN) and solid pseudopapillary epithelial neoplasms (SPEN).
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