The imaging features of epidermoid cyst within intrapancreatic accessory spleen

Abstract

Objective \nTo investigate the imaging features of epidermoid cyst within intrapancreatic accessory spleen (ECIPAS) to make benefits for differential diagnosis of pancreatic lesions. \n \n \nMethods \nWe retrospectively reviewed the clinicalradiological and pathological data of 7 patients with pathologically confirmed ECIPAS.All the cases underwent plain and contrast enhanced CT scan,2 cases underwent magnetic resonance cholangiopancreatography (MRCP), and 5 cases underwent ultrasonic examination. The imaging features of the lesions were analyzed. \n \n \nResults \nCT showed that 5 lesions were situated in the pancreatic tail while the other two located in the neck.The mean size of the lesions was (2.8±1.2) cm,ranging from 1.5 to 4.8 cm. The cysts appeared multiocular in 2 cases. On plain CT, 2 cases showed well-defined low density foci, while 2 cases showed slightly high density. Calcification can be found in 2 cases. In 4 cases, the solid component surrounding the cyst displayed progressive enhancement on postcontrast CT. The enhancement was higher than the pancreatic parenchymaand similar to the spleen during both arterial and portal venous phases. On MRCP,no expansion was shown in pancreatic duct andit had no relationship with cyst in both 2 cases while slightly hypointensity could be found at the back and it pancreatic neck and body in 1 case. Five lesions were hypoechoic or anechoic and irregular-shaped on ultrasound. \n \n \nConclusion \nECIPAS is a rare benign lesion and the typical imaging manifestation is a cyst with surrounding solid component with enhancement similar to the spleen while higher than pancreas. \n \n \nKey words: \nPancreas;\xa0Accessory spleen;\xa0Tomography, X-ray computed;\xa0Magnetic resonance imaging