The results of 72 cases of histologically confirmed pancreatic neoplasm are reviewed. By applying a semeiological scheme, which considers intra and extrapancreatic alterations, it is shown that the possibility of a pre-invasive diagnosis on CT is still limited, and requires further confirmation. CT examination is unique for demonstrating the extension of the lesion, and provides truly probative findings for a specific diagnosis, especially when signs of direct local or distant invasion appear.