PMC5106538_01
62-year-old man with eroding pancreatic pseudocyst. Transverse transabdominal sonogram shows an anechoic small cystic, round, lesion (arrow) that was 1.5 cm in diameter at the region of the pancreatic head.
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Color Doppler scanning revealed incomplete color turbulent filling flow inside the lesion (Figure 1A, Figure 1B).
62-year-old man with eroding pancreatic pseudocyst. Color Doppler sonogram displayed turbulent partial color flow filling of the lesion (arrow) anteriorly located and in direct continuity with the junction between the splenic and portal vein.
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An area of high signal intensity in contact with the porto-splenic junction in T1 and T2 and post Gadolinium-bawee injection was also observed, denoting a subacute blood collection (Figure 2A, Figure 2B, Figure 2C).
62-year-old man with eroding pancreatic pseudocyst. T2-weighted axial MRI shows the presence of intermediate signal intensity oval lesion with well defined margin (white arrow) that contains a rounded well defined area of high signal intensity (white arrow head). The legion appears inseparable from the anterior aspect of the terminal part of splenic vein and its confluence with portal vein (black arrow).
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The pancreas was atrophic with multiple, punctuate, calcific foci predominantly seen in the head and body of the pancreas. 3D reconstructed CT angiography confirmed that the contrast filling of the lesion seen during the portal venous phase was in direct continuity with the terminal course of splenic vein (Figure 3A, Figure 3B, Figure 3C, Figure 3D).
62-year-old man with eroding pancreatic pseudocyst. T1-weighted noncontrast-enhanced axial MRI shows low signal intensity of the lesion (white arrow) with absence of previously described central high signal area in T2.
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These studies once more demonstrated the presence of contrast filling of the lesion during the portal venous phase (Figure 4A, Figure 4B).