Journal of Ultrasound in Medicine, Vol 5, Issue 3 169-177, Copyright © 1986 by American Institute of Ultrasound in Medicine
The spectrum of sonographic findings in pancreatic carcinoma
T. H. Shawker, B. S. Garra, M. C. Hill, J. L. Doppman and W. F. Sindelar
The ultrasound studies of 59 patients with cancer of the pancreas were
reviewed and the findings grouped into two categories: intrapancreatic,
which included the appearance of the primary tumor and the pancreatic duct;
and extrapancreatic, which included biliary obstruction, hepatic
metastases, regional lymph node involvement, ascites, spleen enlargement
and invasion, and alteration of the upper abdominal veins. Pancreatic duct
dilatation was more evident with smaller tumors of the pancreatic head,
while inferior vena cava compression was found not to be a constant finding
even with large tumors of the head of the pancreas. Tumor extension to
regional lymph nodes was difficult to detect and consequently
underestimated. Nonvisualization, occlusion with or without collaterals,
and displacement or deformity of the major branches of the portal venous
system were detectable sonographically. The liver metastases of pancreatic
carcinoma tended to be small and hypoechoic. This is a different pattern
from that typically described for other gastrointestinal adenocarcinomas
and, in particular, markedly different and distinguishable from the
metastatic pattern seen with malignant pancreatic islet cell tumors. The
significance of the intra- and extrapancreatic changes seen sonographically
in cancer of the pancreas by ultrasound is discussed in relationship to
clinical staging and prognosis.
