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Presented by Ralph Hruban, M.D. and prepared by Doreen Nguyen, M.D.
Case 2: This 50 some year old man developed severe abdominal pain.
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Question 1 of 1
1. Question
Week 562: Case 2
This 50 some year old man developed severe abdominal pain. A CT scan revealed a solid and cystic mass lesion involving the head of his pancreas.images/D Nguyen/8-12-13/case 2/2x_450 pixels.jpg
images/D Nguyen/8-12-13/case 2/2x_cyst_450 pixels2.jpg
images/D Nguyen/8-12-13/case 2/4x_cyst_450 pixels.jpg
images/D Nguyen/8-12-13/case 2/4x_inflam_450 pixels.jpg
images/D Nguyen/8-12-13/case 2/10x_fibrosis_450 pixels.jpgCorrect
Answer: Paraduodenal wall cyst
Histology: This large lesion completely replaced the head of the pancreas. Several cysts were present in the pancreatic parenchyma underlying the duodenum near the minor ampulla. These were partially lined by ductal epithelium. The solid parts of the lesion were composed of edematous and inflamed pancreatic parenchyma and bland spindle shaped cells. Proteinaceous concretions were present in some of the ducts.
Discussion: Paraduodenal wall cysts, also known as groove pancreatitis, are non-neoplastic lesions characterized by the formation of cysts in the “groove region” of the pancreas (between the major and minor papillae, the duodenum and the head of the pancreas) and associated reactive spindle cells. There is often an associated acute and chronic pancreatitis, and concretions within the pancreatic ducts. The patients often have a significant history of alcohol abuse.
Incorrect
Answer: Paraduodenal wall cyst
Histology: This large lesion completely replaced the head of the pancreas. Several cysts were present in the pancreatic parenchyma underlying the duodenum near the minor ampulla. These were partially lined by ductal epithelium. The solid parts of the lesion were composed of edematous and inflamed pancreatic parenchyma and bland spindle shaped cells. Proteinaceous concretions were present in some of the ducts.
Discussion: Paraduodenal wall cysts, also known as groove pancreatitis, are non-neoplastic lesions characterized by the formation of cysts in the “groove region” of the pancreas (between the major and minor papillae, the duodenum and the head of the pancreas) and associated reactive spindle cells. There is often an associated acute and chronic pancreatitis, and concretions within the pancreatic ducts. The patients often have a significant history of alcohol abuse.
