Chi Ming Lee

Differential Diagnosis of Cystic Lymphangioma of the Pancreas Based on Imaging Features

Lymphangioma is a benign tumor, which is a consequence of lymphatic malformation with blockage of lymphatic flow. Most lymphangiomas occur in the neck and axillary region, and < 1% occur in the mesentery or retroperitoneum. Lymphangiomas arising from the pancreas are extremely rare. We report the case of a 34-year-old woman with cystic lymphangioma of the pancreas without major symptoms or signs. A 6 x 6 cm intra-abdominal cystic mass was incidentally revealed by sonography during a health examination. It is always a challenge to differentiate the lesion from other possible cystic-like pancreatic neoplasms. Differential diagnosis of cystic lymphangioma from other cystic-like tumors of the pancreas can be performed based on their imaging characteristics, including presence of septa, cystic or wall calcification, soft tissue, wall thickness, single or multiple loculation, and dilatation of the pancreatic duct. Post-gadolinium magnetic resonance imaging is excellent in defining the origin of intra-abdominal cystic mass and intracystic septa.

Magnetic Resonance Cholangiopancreatography of Anatomic Variants of the Biliary Tree in Taiwanese

BACKGROUND AND PURPOSEnMagnetic resonance cholangiopancreatography (MRCP) is a non-invasive method for evaluating the hepatobiliary system. This study investigated the anatomic variants of the biliary tree in Taiwanese using MRCP.nnnMETHODSn170 patients with abdominal or liver diseases underwent diagnostic MRCP over the 29-month study period. We identified the type of biliary tree variants in 130 patients.nnnRESULTSnThe imaging findings showed that the most common biliary tree variants were type I and type IIA, which together comprised 70% of all variants. Type I is a triple confluence, which is an anatomy characterized by simultaneous emptying of the right posterior segment duct, right anterior segment duct, and left hepatic duct into the common hepatic duct. Type IIA involves drainage of the right posterior segment duct into the right anterior segment duct to form the right hepatic duct, and then confluence with the left hepatic duct to form the common hepatic duct. There was a mean percentage of 10 to 20% among the 7 types of variants identified.nnnCONCLUSIONnComparison of these findings with previous investigation indicates that biliary tract structure shows racial and ethnic variation.