PMC4897037_01
46-year-old man with pancreatic neuroendocrine tumor. Transverse sonogram of the region of the pancreas shows a diffusely enlarged pancreas with extensive calcifications. PV = Portal Venous Confluence.
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Marked pancreatic enlargement was found with extensive speckled calcifications and a few cystic areas (Fig. 1).
Contrast-enhanced CT shows a markedly enlarged pancreas with extensive calcifications and cysts.
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Evaluation of the pancreas revealed it to be markedly enlarged with extensive calcifications and a few cysts (Fig.2AB), but without surrounding inflammation.
46-year-old man with pancreatic neuroendocrine tumor and incidental hepatic dome hemangioma. MRI shows (A) T1 hypointense and (B) T2 hyperintense hepatic dome lesion with progressive centripetal enhancement on (C) portal venous phase and (D) delayed imaging.
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MRI of the abdomen suggested an atypical hepatic hemangioma (Fig. 3) and confirmed a massively enlarged pancreas containing multiple calcifications and tiny cysts without contour deformity or involvement of the surrounding soft tissue structures (Fig.4 A-D). TE = 1.328 ms) images demonstrated the pancreas to be isointense to the liver (Fig. 3A). The pancreas was slightly increased in intensity with respect to the liver on T2-weighted images (TR = 991.744 ms; TE = 118.56 ms) (Fig. 3B). T1-weighted fat saturation post contrast images (TR = 120 ms; TE = 1.328 ms) demonstrated minimal enhancement in the arterial phase (Fig. 3C) and progressive enhancement in the portal venous phase (Fig. 3D). The pancreatic duct and the visualized portions of the pancreatic duct were unremarkable.
(A) Gross specimen shows generalized enlargement of pancreas with extensive nodularity and calcifications representing diffuse tumor involvement. (B) Photomicrograph shows uniformity and cellular features typical of neuroendocrine tumor (H and E, 100x).
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The patient died two months later and a limited autopsy of the pancreas again showed a diffusely enlarged infiltrated pancreas, which measured 32 x 16 x 11 cm in size and weighed 1850 grams (Fig.5).