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ABDOMEN / GI tract general   36 / F,  No specific symptom
About Author
Authors Sunyoung Lee
Institution Severance Hospital, Yonsei University College of Medicine
E-mail carnival0126@gmail.com
About Case
Chief complaint
or Title
No specific symptom
Subspecialty ABDOMEN / GI tract general
Classification Other / others
Age 36 Sex F
Difficulty For resident, For specialist
Modality CT, Etc
Case Figures
Click above Figure for more images.
Questions
What is your most likely diagnosis of this lesion?
Answer
Diagnosis Heterotopic Pancreas
Comments

Heterotopic Pancreas

 

Separated from main gland
M/C in upper GI tract
:
stomach(25.5%), duodenum(27.7%), proximal jejunum(15.9%)
Less common : esophagus, ileum, Meckel diverticulum, biliary tree, spleen & mesentery
Sx
Asymptomatic : Uncomplicated HP incidentally discovered by surgery, imaging etc.
Epigastric pain, chronic abdominal pain, nausea, vomiting, weight loss(rare)
CT findings – small oval intramural mass with microlobulated margin and endoluminal growth pattern
Acinus-dominant lesion : homogeneous enhancement
Duct-dominant lesion : heterogeneous and hypovascular
MR findings
T1 – isointense to normal pancreas, with T1 hyperintensity after Gd-based contrast(arterial phase)
Rudimentary ductal system – orifice visible as a central umbilication in lesion
Complications
Pancreatitis, pseudocyst, malignant degeneration, GI bleeding, bowel obstruction, intussusception etc.

References Radio Graphics 2017; 37:484–499
Keywords Heterotopic Pancreas
Attachment File -

Number of Applicants : 40
Correct Answer 9
Mayo Clinic Akitoshi Inoue
KSAR Dr K
Nagahama City Hospital Ryo Uemura
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