Summary
Endoscopic ultrasonography (EUS) was performed in 40 patients with pancreatic masses
who subsequently underwent surgical resection, and we compared the ultrasonograms
with the histopathologic findings. Ductal adenocarcinoma: The cephalad margin between
the tumor and pancreatic tissue was distinct, while the caudal margin was blurred
because of severe fibrosis accompanying secondary pancreatitis, and the contour of
the tumor was irregular. The internal echo pattern was hypoechoic, with an uneven
central echogenic portion corresponding to irregularly arranged carcinomatous canaliculi
or coagulation necrosis. Benign islet cell tumor: Both the cephalad and caudal margins
were distinct, the contour was smooth and the internal echo pattern was hypoechoic,
with a homogeneous central echogenic portion corresponding to regularly arranged alveoli.
Pseudotumorous pancreatitis: The caudal margin was indistinct, the contour was smooth,
and the internal echo pattern was homogeneously hypoechoic, with deep attenuation
caused by dense fibrosis. On the basis of these results, it is believed that EUS with
its high resolution is useful in the differential diagnosis of pancreatic mass lesions.
Key words:
Endoscopic ultrasonography - Pancreatic cancer - Benign islet cell tumor - Malignant
islet cell tumor - Pseudotumorous pancreatitis
