Review
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World J Gastroenterol. Nov 21, 2011; 17(43): 4757-4771
Published online Nov 21, 2011. doi: 10.3748/wjg.v17.i43.4757
Spectrum of mucin-producing neoplastic conditions of the abdomen and pelvis: Cross-sectional imaging evaluation
Nam Kyung Lee, Suk Kim, Hyun Sung Kim, Tae Yong Jeon, Gwang Ha Kim, Dong Uk Kim, Do Youn Park, Tae Un Kim, Dae Hwan Kang
Nam Kyung Lee, Suk Kim, Department of Radiology, Pusan National University Hospital and Medical Research Institute, Pusan National University School of Medicine, Pusan National University, Busan 602-739, South Korea
Hyun Sung Kim, Tae Yong Jeon, Department of Surgery, Pusan National University Hospital and Medical Research Institute, Pusan National University School of Medicine, Pusan National University, Busan 602-739, South Korea
Gwang Ha Kim, Dong Uk Kim, Department of Internal Medicine, Pusan National University Hospital and Medical Research Institute, Pusan National University School of Medicine, Pusan National University, Busan 602-739, South Korea
Do Youn Park, Department of Pathology, Pusan National University Hospital and Medical Research Institute, Pusan National University School of Medicine, Pusan National University, Busan 602-739, South Korea
Tae Un Kim, Department of Radiology, Yangsan Pusan National University Hospital and Medical Research Institute, Pusan National University School of Medicine, Pusan National University, Yangsan 626-770, South Korea
Dae Hwan Kang, Department of Internal Medicine, Yangsan Pusan National University Hospital and Medical Research Institute, Pusan National University School of Medicine, Pusan National University, Yangsan 626-770, South Korea
Author contributions: Kim S contributed to study conception and design; Lee NK, Kim HS, Jeon TY, Kim GH, Kim DU, Park DY, Kim TU, and Kang DH contributed to acquisition of data, or analysis and interpretation of data; Lee NK and Kim S contributed to drafting the article or revising it critically for important intellectual content; Kim S gave final approval of the version to be published.
Supported by A grant from the Korea Healthcare Technology R and D Project, Ministry for Health, Welfare, and Family Affairs, South Korea, A091047
Correspondence to: Suk Kim, MD, Department of Radiology, Pusan National University Hospital and Medical Research Institute, Pusan National University School of Medicine, Pusan National University, No. 1-10, Ami-Dong, Seo-Gu, Busan 602-739, South Korea. kimsuk@medimail.co.kr
Telephone: +82-51-2407354 Fax: +82-51-2447534
Received: February 23, 2011
Revised: March 29, 2011
Accepted: April 5, 2011
Published online: November 21, 2011
Abstract

Various mucin-producing neoplasms originate in different abdominal and pelvic organs. Mucinous neoplasms differ from non-mucinous neoplasms because of the differences in clinical outcome and imaging appearance. Mucinous carcinoma, in which at least 50% of the tumor is composed of large pools of extracellular mucin and columns of malignant cells, is associated with a worse prognosis. Signet ring cell carcinoma is characterized by large intracytoplasmic mucin vacuoles that expand in the malignant cells with the nucleus displaced to the periphery. Its prognosis is also generally poor. In contrast, intraductal papillary mucinous neoplasm of the bile duct and pancreas, which is characterized by proliferation of ductal epithelium and variable mucin production, has a better prognosis than other malignancies in the pancreaticobiliary tree. Imaging modalities play a critical role in differentiating mucinous from non-mucinous neoplasms. Due to high water content, mucin has a similar appearance to water on ultrasound (US), computed tomography (CT), and magnetic resonance imaging, except when thick and proteinaceous, and then it tends to be hypoechoic with fine internal echoes or have complex echogenicity on US, hyperdense on CT, and hyperintense on T1- and hypointense on T2-weighted images, compared to water. Therefore, knowledge of characteristic mucin imaging features is helpful to diagnose various mucin-producing neoplastic conditions and to facilitate appropriate treatment.

Keywords: Mucin; Neoplasm; Ultrasound; Computed tomography; Magnetic resonance; Abdomen and pelvis