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© 2005 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 24:849-854 • 0278-4297

Case Series

Contrast-Enhanced Ultrasonography of Small Solid Pseudopapillary Tumors of the Pancreas

Enhancement Pattern and Pathologic Correlation of 2 Cases

Mirko D’Onofrio, MD, Roberto Malagò, MD, Francesca Vecchiato, MD, Giulia Zamboni, MD, Marco Testoni, MD, Massimo Falconi, MD, Paola Capelli, MD and Roberto Pozzi Mucelli, MD

Departments of Radiology (M.D., R.M., F.V., G.Z., M.T., R.P.M.), Surgery (M.F.), and Pathology (P.C.), University of Verona, Verona, Italy.

Address correspondence to Mirko D’Onofrio, MD, Department of Radiology, Policlinico G. B. Rossi, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy. E-mail: mirkodonofrio{at}univr.it

Objective. The purpose of this series is to describe the value of contrast-enhanced ultrasonography (CEUS) in the characterization of small pseudopapillary tumors (SPTs) of the pancreas. Methods. Two cases of SPTs found on conventional ultrasonography, both located at the pancreatic body, were studied with spiral computed tomography, magnetic resonance imaging, and CEUS. A final diagnosis was obtained with histologic analysis after distal pancreatectomy. Immunohistochemical analysis of the tumors with the CD34 antigen was performed. Results. At CEUS, the 2 SPTs had a slight peripheral rim enhancement in the early dynamic phases. The presence of this enhancement pattern at CEUS, not clear at spiral computed tomography or at magnetic resonance imaging, suggested the diagnosis of SPTs with a peripheral pseudocapsule deriving from the compression of the pancreatic parenchyma. The presence of a perilesional pseudocapsule was proved at immunohistochemical analysis of the tumors with the CD34 antigen. Conclusions. Contrast-enhanced ultrasonography can improve the characterization of SPTs by showing the typical rim enhancement of these pancreatic tumors.

Key Words: contrast-enhanced ultrasonography • immunohistochemical analysis • pancreatic tumors • spiral computed tomography

Abbreviations: CEUS, contrast-enhanced ultrasonography • CT, computed tomography • MR, magnetic resonance • SPT, small pseudopapillary tumor • TSE, turbo spin echo




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