Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 14, 2013; 19(34): 5713-5719
Published online Sep 14, 2013. doi: 10.3748/wjg.v19.i34.5713
Comparison of pancreatic acinar cell carcinoma and adenocarcinoma using multidetector-row computed tomography
Tatsuaki Sumiyoshi, Yasuo Shima, Takehiro Okabayashi, Akihito Kozuki, Toshio Nakamura
Tatsuaki Sumiyoshi, Yasuo Shima, Takehiro Okabayashi, Akihito Kozuki, Toshio Nakamura, Departments of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi 781-8555, Japan
Author contributions: Sumiyoshi T, Shima Y, Okabayashi T, Kozuki A and Nakamura T contributed equally to the writing of this paper.
Correspondence to: Tatsuaki Sumiyoshi, MD, Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125 Ike, Kochi 781-8555, Japan. tasu050520@yahoo.co.jp
Telephone: +81-88-8373000 Fax: +81-88-8376766
Received: January 12, 2013
Revised: May 4, 2013
Accepted: July 12, 2013
Published online: September 14, 2013
Processing time: 244 Days and 22.8 Hours
Abstract

AIM: To distinguish acinar cell carcinoma (ACC) from pancreatic adenocarcinoma (AC) by comparing their computed tomography findings.

METHODS: Patients with ACC and AC were identified on the basis of results obtained using surgically resected pancreatectomy specimens. The preoperative computer tomographic images of 6 acinar cell carcinoma patients and 67 pancreatic adenocarcinoma patients in 4 phases (non-contrast, arterial, portal venous, and delayed phase) were compared. The scan delay times were 40, 70, and 120 s for each contrast-enhanced phase. The visual pattern, tomographic attenuation value, and time attenuation curve were assessed and compared between AC and ACC cases using the χ2 test, Wilcoxon signed-rank test, and Mann Whitney U test.

RESULTS: The adenocarcinomas tended to be hypodense in all 4 phases. The acinar cell carcinomas also tended to be hypodense in the 3 contrast-enhanced phases, although their computed tomographic attenuation values were higher. Further, 5 of the 6 acinar cell carcinomas (83%) were isodense in the non-contrast phase. The time attenuation curve of the adenocarcinomas showed a gradual increase through the 4 phases, and all adenocarcinomas showed peak enhancement during the delayed phase. The time attenuation curve of the acinar cell carcinomas showed peak enhancement during the portal venous phase in 4 cases and during the arterial phase in 2 cases. None of the 6 acinar cell carcinomas showed peak enhancement during the delayed phase.

CONCLUSION: The tumor density in the non-contrast phase and time attenuation curve pattern clearly differ between acinar cell carcinomas and adenocarcinomas, and multidetector-row computed tomography can thus distinguish these tumors.

Keywords: Pancreatic acinar cell carcinoma; Pancreatic adenocarcinoma; Multidetector-row computed tomography; Visual pattern; Time attenuation curve

Core tip: The tumor density in the non-contrast phase and time attenuation curve pattern clearly differ between acinar cell carcinoma and adenocarcinomas, although both tumors tend to be hypodense in the contrast-enhanced phases.