Korean Journal of Gastrointestinal Endoscopy 2006;32(2): 109-115.
췌장의 대낭성 장액성 낭종과 점액성 낭종의 감별 진단에 있어서 내시경 초음파의 유용성
정석원·이상수·김규표·송문희·한지민·김종철·최은광·주영민·서동완·이성구·김명환·장세진*
울산대학교 의과대학 서울아산병원 내과, *병리과
Can EUS Help to Differentiate Macrocystic Serous Cystadenoma from Mucinous Cystadenoma of the Pancreas by Its Morphologic Characteristics?
Seok Won Jung, M.D., Sang Soo Lee, M.D., Kyu Pyo Kim, M.D., Moon Hee Song, M.D., Jimin Han, M.D., Jong Cheol Kim, M.D., Eun Kwang Choi, M.D., Young Min Joo, M.D., Dong Wan Seo, M.D., Sung Koo Lee, M.D., Myung-Hwan Kim, M.D. and Se Jin Jang, M.D.*
Departments of Internal Medicine and *Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Abstract
Background/Aims: A macrocystic variant of a serous cystadenoma (M-SCA) is usually indistinguishable from a mucinous cystadenoma (MCA) as a result of their morphologic similarity on conventional imaging studies. However, a MCA requires a resection due to its malignant potential. The aim of this study was to determine the EUS morphological characteristics of a M-SCA to determine if they could be used to help differentiate it from MCA. Methods: The clinical and EUS morphologic characteristics were examined in 31 consecutive patients with M-SCA and MCA who underwent surgery. Results: Resected specimens were available from 11 M-SCAs and 20 MCAs. Significant differences were observed with regard to the age and location within the pancreas. On EUS, most of the M-SCA contained microcysts (82%) compared with only 15% of MCA cases, and a lobulated configuration of the cyst was observed more frequently in the M-SCA cases than in the MCA (91% vs. 25%). The combination of microcysts and the lobulated configuration of the cysts had a 100% specificity and positive predictive value for differentiating M-SCA from MCA. Conclusions: M-SCA tends to occur at a relatively younger age than MCA, and is located mainly in the head of the pancreas. Although there is considerable morphological similarity between M-SCA and MCA on the conventional imaging modalities, the morphological characteristics obtained from EUS including microcysts with a lobulated configuration may help to make a distinction between M-SCA and MCA. (Korean J Gastrointest Endosc 2006;32:109115)
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