Pancreatic cancer differential diagnosis: Difference between revisions

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| style="background:#DCDCDC; + " | '''Pancreas'''
| style="background:#DCDCDC; + " | '''Pancreas'''
|
|
* Chronic pancreatitis
* [[Chronic pancreatitis]]
* Autoimmune pancreatitis
* [[Autoimmune pancreatitis]]
* Pseudocyst of pancreas
* [[Pancreatic pseudocyst|Pseudocyst]] of [[pancreas]]
* Neuroendocrine tumors of pancreas
* [[Neuroendocrine tumors|Neuroendocrine tumors of pancreas]]
** Gastrinoma
** [[Gastrinoma (patient information)|Gastrinoma]]
** VIPoma
** [[VIPoma]]
** Somatostatinoma
** [[Neuroendocrine tumors|Somatostatinoma]]
** Insulinoma
** [[Insulinoma]]
|
|
* Imaging: Non-contrast helical CT
* Imaging: Non-contrast helical [[Computed tomography|CT]]
* Biopsy findings
* Biopsy findings
* Serum IgG4 levels for autoimmune pancreatitis
* Serum [[IgG4-related systemic disease|IgG4]] levels for autoimmune pancreatitis
* For pancreatic NETs:
* For pancreatic [[Neuroendocrine tumors|NETs]]:
** Gastrin levels
** [[Gastrin]] levels
** Somatostatin levels
** [[Somatostatin]] levels
** Insulin levels
** [[Insulin]] levels
** Serum electrolytes
** Serum electrolytes
|-
|-
| style="background:#DCDCDC; + " | '''Bile duct'''
| style="background:#DCDCDC; + " | '''Bile duct'''
|
|
* Choledocholithiasis
* [[Choledocholithiasis]]
* Gallstones (Cholelithiasis)
* [[Gallstone disease|Gallstones]] ([[Gallstone disease|Cholelithiasis]])
* Choledochal Cysts
* [[Bile duct cyst|Choledochal Cysts]]
* Cholangiocarcinoma
* [[Cholangiocarcinoma]]
* Bile duct strictures
* [[Bile duct]] [[Stenosis|strictures]]
* Cholangitis
* [[Cholangitis]]
* Cholecystitis
* [[Cholecystitis]]
|
|
* Imaging:
* Imaging:
** MRI
** [[Magnetic resonance imaging|MRI]]
** MRCP
** [[Magnetic resonance cholangiopancreatography|MRCP]]
** USG bile duct
** [[Ultrasound|USG bile duct]]
** ERCP
** [[Endoscopic retrograde cholangiopancreatography|ERCP]]
* Biopsy findings
* [[Biopsy]] findings
|-
|-
| style="background:#DCDCDC; + " | '''Duodenum'''
| style="background:#DCDCDC; + " | '''Duodenum'''
|
|
* Ampullary cancer
* Ampullary cancer
* Duodenal cancer
* [[Duodenum|Duodenal]] cancer
|
|
* Imaging:  
* Imaging:  
** MRI
** [[Magnetic resonance imaging|MRI]]
** ERCP
** [[Endoscopic retrograde cholangiopancreatography|ERCP]]
** Upper GI Endoscopy
** Upper [[Gastrointestinal tract|GI]] [[Endoscopy]]
* Biopsy findings
* [[Biopsy]] findings
|-
|-
| style="background:#DCDCDC; + " | '''Lymphovascular'''
| style="background:#DCDCDC; + " | '''Lymphovascular'''
'''tissue'''
'''tissue'''
|
|
* Abdominal aortic aneurysm
* [[Abdominal aortic aneurysm]]
* Intestinal ischemia
* [[Mesenteric ischemia|Intestinal ischemia]]
* Lymphomas
* [[Lymphoma|Lymphomas]]
** Gastric
** [[Stomach|Gastric]]
** Pancreatic
** [[Pancreas|Pancreatic]]
|
|
* Imaging:  
* Imaging:  
** MRI  
** [[Magnetic resonance imaging|MRI]]
** MR Angiography
** MR [[Angiogram|Angiography]]
** CT Angiography
** CT [[Angiogram|Angiography]]
* Biopsy for lymphoma
* [[Biopsy]] for [[lymphoma]]
|-
|-
| style="background:#DCDCDC; + " | '''Metastasis'''
| style="background:#DCDCDC; + " | '''Metastasis'''
|
|
* Skin(Melanoma)
* [[Skin]]([[Melanoma]])
* Kidney
* [[Kidney]]
* Breast
* [[Breast]]
* Colon
* [[Colon (anatomy)|Colon]]
* Liver(Hepatocellular carcinoma)
* [[Liver]]([[Hepatocellular carcinoma]])
* Stomach
* [[Stomach]]
|
|
* Imaging:  
* Imaging:  
** MRI
** [[Magnetic resonance imaging|MRI]]
** PET scan
** [[Positron emission tomography|PET scan]]
** CT
** [[Computed tomography|CT]]
* Biopsy
* [[Biopsy]]
* Specific markers for different cancers:
* Specific markers for different [[Cancer|cancers]]:
** HCC: AFP
** [[Hepatocellular carcinoma|HCC]]: [[Alpha-fetoprotein|AFP]]
** Breast: BRCA 1 and 2
** [[Breast]]: ''BRCA 1 and 2''
** Colon cancer: CEA
** [[Colorectal cancer|Colon cancer]]: [[CEA]]
** Melanoma: S100
** [[Melanoma]]: [[S100B|S100]]
|}
|}


Revision as of 14:11, 15 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]

Overview

Pancreatic cancer must be differentiated from choledocholithiasis, pancreatic pseudocyst, cystic neoplasm and carcinoma of the biliary tract

Differentiating Pancreatic Cancer from other Diseases

The differentials for pancreatic cancer mainly involve pathologies of the pancreas, bile duct, duodenum, lymphovascular tissue or metastasis from other sites:[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]

Origin Disease Differentiation based on Investigations
Pancreas
  • Imaging: Non-contrast helical CT
  • Biopsy findings
  • Serum IgG4 levels for autoimmune pancreatitis
  • For pancreatic NETs:
Bile duct
Duodenum
Lymphovascular

tissue

Metastasis

References

  1. ↑ He XK, Ding Y, Sun LM (2017). "Contrast-enhanced endoscopic ultrasound for differential diagnosis of pancreatic cancer: an updated meta-analysis". Oncotarget. 8 (39): 66392–66401. doi:10.18632/oncotarget.18915. PMC 5630421. PMID 29029521.
  2. ↑ Steinman J, Zaheer A, Kluger MD, Remotti H, Hecht EM (2017). "Rare pancreatic tumors". Abdom Radiol (NY). doi:10.1007/s00261-017-1342-x. PMID 29022085.
  3. ↑ Ran L, Zhao W, Zhao Y, Bu H (2017). "Value of contrast-enhanced ultrasound in differential diagnosis of solid lesions of pancreas (SLP): A systematic review and a meta-analysis". Medicine (Baltimore). 96 (28): e7463. doi:10.1097/MD.0000000000007463. PMC 5515757. PMID 28700485.
  4. ↑ Kołodziejczyk E, Wejnarska K, Oracz G (2016). "Autoimmune pancreatitis in the paediatric population - review of the literature and own experience". Dev Period Med. 20 (4): 279–286. PMID 28216481.
  5. ↑ Zhu L, Xue HD, Liu W, Wang X, Sui X, Wang Q, Zhang D, Li P, Jin ZY (2017). "Enhancing pancreatic mass with normal serum CA19-9: key MDCT features to characterize pancreatic neuroendocrine tumours from its mimics". Radiol Med. 122 (5): 337–344. doi:10.1007/s11547-017-0734-x. PMID 28197876.
  6. ↑ Sano I, Katanuma A, Yane K, Kin T, Nagai K, Yamazaki H, Koga H, Kitagawa K, Yokoyama K, Ikarashi S, Takahashi K, Maguchi H, Omori Y, Shinohara T (2017). "Pancreatic Metastasis from Rectal Cancer that was Diagnosed by Endoscopic Ultrasonography-guided Fine Needle Aspiration (EUS-FNA)". Intern. Med. 56 (3): 301–305. doi:10.2169/internalmedicine.56.7213. PMC 5348454. PMID 28154274.
  7. ↑ Salaria SN, Shi C (2016). "Pancreatic Neuroendocrine Tumors". Surg Pathol Clin. 9 (4): 595–617. doi:10.1016/j.path.2016.05.006. PMID 27926362.
  8. ↑ Kawasaki K, Kawaguchi Y, Suzuki Y, Tanaka N (2016). "Renal neuroendocrine tumour and synchronous pancreas metastasis: histopathological diagnosis using prostatic acid phosphatase". BMJ Case Rep. 2016. doi:10.1136/bcr-2016-214759. PMID 27803081.
  9. ↑ Nassour I, Choti MA (2016). "Diagnosis and Treatment of Pancreatic Cystic Neoplasms". JAMA. 316 (12): 1326. doi:10.1001/jama.2016.9130. PMID 27673319.
  10. ↑ Javadi S, Menias CO, Korivi BR, Shaaban AM, Patnana M, Alhalabi K, Elsayes KM (2017). "Pancreatic Calcifications and Calcified Pancreatic Masses: Pattern Recognition Approach on CT". AJR Am J Roentgenol. 209 (1): 77–87. doi:10.2214/AJR.17.17862. PMID 28418702.
  11. ↑ Bergmann F (2016). "[Pancreatic acinar neoplasms : Comparative molecular characterization]". Pathologe (in German). 37 (Suppl 2): 191–195. doi:10.1007/s00292-016-0235-z. PMID 27807633.
  12. ↑ Cheng SK, Chuah KL (2016). "Metastatic Renal Cell Carcinoma to the Pancreas: A Review". Arch. Pathol. Lab. Med. 140 (6): 598–602. doi:10.5858/arpa.2015-0135-RS. PMID 27232353.
  13. ↑ Haage P, Schwartz CA, Scharwächter C (2016). "[Ductal adenocarcinoma and unusual differential diagnosis]". Radiologe (in German). 56 (4): 325–37. doi:10.1007/s00117-016-0090-1. PMID 27000276.
  14. ↑ Scialpi M, Reginelli A, D'Andrea A, Gravante S, Falcone G, Baccari P, Manganaro L, Palumbo B, Cappabianca S (2016). "Pancreatic tumors imaging: An update". Int J Surg. 28 Suppl 1: S142–55. doi:10.1016/j.ijsu.2015.12.053. PMID 26777740.
  15. ↑ Senosiain Lalastra C, Foruny Olcina JR (2015). "[Autoimmune pancreatitis]". Gastroenterol Hepatol (in Spanish; Castilian). 38 (9): 549–55. doi:10.1016/j.gastrohep.2015.01.006. PMID 25799073.
  16. ↑ Barbier L, Delpero JR (2014). "[Pancreatic tumours]". Rev Prat (in French). 64 (9): 1307–12. PMID 25638877.
  17. ↑ Díte P, Uvírová M, Bojková M, Novotný I, Dvorácková J, Kianicka B, Nechutová H, Dovrtelová L, Floreánová K, Martínek A (2014). "Differentiating autoimmune pancreatitis from pancreatic cancer". Minerva Gastroenterol Dietol. 60 (4): 247–53. PMID 25288201.
  18. ↑ Lalwani N, Mannelli L, Ganeshan DM, Shanbhogue AK, Dighe MK, Tiwari HA, Maximin S, Monti S, Ragucci M, Prasad SR (2015). "Uncommon pancreatic tumors and pseudotumors". Abdom Imaging. 40 (1): 167–80. doi:10.1007/s00261-014-0189-7. PMID 25063236.
  19. ↑ Dite P, Nechutova H, Uvirova M, Dvorackova J, Kianicka B, Martinek A (2014). "Autoimmune pancreatitis". Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 158 (1): 17–22. doi:10.5507/bp.2013.094. PMID 24572485.
  20. ↑ Mastoraki A, Tzortzopoulou A, Tsela S, Danias N, Sakorafas G, Smyrniotis V, Arkadopoulos N (2014). "Hereditary pancreatitis: dilemmas in differential diagnosis and therapeutic approach". J Gastrointest Cancer. 45 (1): 22–6. doi:10.1007/s12029-013-9559-6. PMID 24242859.
  21. ↑ Beyer G, Menzel J, Krüger PC, Ribback S, Lerch MM, Mayerle J (2013). "[Autoimmune pancreatitis]". Dtsch. Med. Wochenschr. (in German). 138 (46): 2359–70, quiz 2371–4. doi:10.1055/s-0033-1349475. PMID 24193862.
  22. ↑ Al-Hawary MM, Kaza RK, Azar SF, Ruma JA, Francis IR (2013). "Mimics of pancreatic ductal adenocarcinoma". Cancer Imaging. 13 (3): 342–9. doi:10.1102/1470-7330.2013.9012. PMC 3800430. PMID 24060833.
  23. ↑ Bednar F, Scheiman JM, McKenna BJ, Simeone DM (2013). "Breast cancer metastases to the pancreas". J. Gastrointest. Surg. 17 (10): 1826–31. doi:10.1007/s11605-013-2291-5. PMID 23918083.
  24. ↑ DiMagno MJ, DiMagno EP (2013). "Chronic pancreatitis". Curr. Opin. Gastroenterol. 29 (5): 531–6. doi:10.1097/MOG.0b013e3283639370. PMC 4387887. PMID 23852141.

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