CT and MRI features of undifferentiated carcinomas with osteoclast-like giant cells of the pancreas: a case series

Abdom Radiol (NY). 2019 Apr;44(4):1246-1255. doi: 10.1007/s00261-019-01958-9.

Abstract

Purpose: The purpose of this case series was to describe computed tomography (CT) and magnetic resonance imaging (MRI) features of undifferentiated carcinoma with osteoclast-like giant cells of the pancreas.

Methods: Institutional ethics review board approval was obtained, and informed consent was waived for this case series. We reviewed CT and MRI of patients with pathologically confirmed undifferentiated carcinoma with osteoclast-like giant cells of the pancreas found in the medical records of our hospital between 2006 and 2016.

Results: Seven patients (3 males and 4 females; age, 59-82 years (mean, 71)) with confirmation by surgical resection (n = 3) or biopsy (n = 4) were identified. They underwent CT (n = 7) and MRI (n = 6). The tumors 26-83 mm in diameter (mean, 44 mm) were located in the head (n = 4) or body (n = 3) of the pancreas. They were demonstrated as lower attenuation areas relative to the adjacent pancreas on CT images obtained in both pancreatic and portal vein phases (n = 7) with a well-defined smooth margin (n = 5). They were demonstrated as hypointense areas relative to the pancreas on T2-weighted images (n = 4) and T2*-weighted images (n = 4) and diffusion-weighted images (n = 3). They contained hemosiderin deposits on histology (n = 7).

Conclusions: Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas might be present as low attenuation areas with a well-defined smooth margin on CT images obtained in pancreatic and portal vein phases, and hypointense areas on T2-, T2*-, and diffusion-weighted images caused by hemosiderin deposits.

Keywords: Magnetic resonance imaging; Multidetector computed tomography; Pancreatic neoplasm; Undifferentiated carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma / diagnostic imaging*
  • Carcinoma / pathology
  • Female
  • Giant Cells / pathology*
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Osteoclasts / pathology*
  • Pancreas / diagnostic imaging
  • Pancreas / pathology
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / pathology
  • Tomography, X-Ray Computed / methods*