A percutaneous pancreaticogram was done which revealed a round filling defect of 15 mm occupying the main pancreatic duct
in the region of the head of pancreas raising the possibility of a mucinous ductal neoplasm.
Pancreatic endocrine tumors with intraductal growth into the main pancreatic duct
and tumor thrombus within the portal vein: a case report and review of the literature.
MRCP can delineate fluid-filled structures such as the main pancreatic duct
and pseudocyst with good accuracy.
IPMNs originate in the distal main pancreatic duct
in 80% of cases.
Many pseudocysts demonstrate communication with the main pancreatic duct
, best seen with either ERCP or MRCP.
The resected pancreas, measuring 12 cm in length, showed a markedly dilated, main pancreatic duct
with intraductal papillary growths, mainly along the body of the pancreas but also involving the proximal pancreatic duct, and, to a lesser degree, the distal pancreatic duct (Figure 1).
EUS criteria included hyperechoic foci, hyperechoic strands, parenchymal lobularity, irregular main pancreatic duct
margins, hyperechoic main pancreatic duct
margins, visible side branch budding, main pancreatic duct
dilatation, shadowing calcifications, and cysts; the presence of four or more criteria was used for diagnosis of CP (24, 25).
Demonstrates communication to main pancreatic duct
on MRCP [right arrow] management.
Its frequency increases with pancreatic division at the body level (vs at the neck) and in the absence of elective ligation of the main pancreatic duct
Morphological features of chronic pancreatitis on s-MRCP include an irregular, dilated main pancreatic duct
and dilated side branches.
The former may be caused by incomplete obstruction of the main pancreatic duct
, whereas the latter occurred as a result of almost complete obstruction of the main pancreatic duct
, similar to that in patients with carcinoma of the head of the pancreas.
Histopathologically, the walls of the main pancreatic duct
and most of its larger interlobular branches were found to have a patchy, dense, lymphoplasmacytic infiltration with occasional eosinophils (Figures 1 and 2).