“Honeycomb” appearance in large-duct type pancreatic ductal adenocarcinoma: Case report with radiologic–pathologic correlation

Ayaka Hara, MD; Yasunari Yamada, MD; Kengo Fukuzawa, MD; Mitsuteru Motomura, MD; Yusuke Kuboyama, MD; Kazuhito Sakata, MD; Ryo Takaji, MD; Yoshiki Asayama, MD; Hajime Takaki, MD

Radiology Case Reports (Sep 2022)

“Honeycomb” appearance in large-duct type pancreatic ductal adenocarcinoma: Case report with radiologic–pathologic correlation

Ayaka Hara, MD,
Yasunari Yamada, MD,
Kengo Fukuzawa, MD,
Mitsuteru Motomura, MD,
Yusuke Kuboyama, MD,
Kazuhito Sakata, MD,
Ryo Takaji, MD,
Yoshiki Asayama, MD,
Hajime Takaki, MD

Affiliations

Ayaka Hara, MD: Department of Radiology, Oita Red Cross Hospital, Chiyo-machi, Oita, Japan
Yasunari Yamada, MD: Department of Radiology, Oita Red Cross Hospital, Chiyo-machi, Oita, Japan; Correspondence author.
Kengo Fukuzawa, MD: Department of Surgery, Oita Red Cross Hospital, Chiyo-machi, Oita, Japan
Mitsuteru Motomura, MD: Department of Hepato-Biliary-Pancreatic Internal Medicine, Oita Red Cross Hospital, Chiyo-machi, Oita, Japan
Yusuke Kuboyama, MD: Department of Pathology, Oita Red Cross Hospital, Chiyo-machi, Oita, Japan
Kazuhito Sakata, MD: Department of Surgery, Oita Red Cross Hospital, Chiyo-machi, Oita, Japan
Ryo Takaji, MD: Department of Radiology, Oita University Faculty of Medicine, Yufu, Oita, Japan
Yoshiki Asayama, MD: Department of Radiology, Oita University Faculty of Medicine, Yufu, Oita, Japan
Hajime Takaki, MD: Department of Radiology, Oita Red Cross Hospital, Chiyo-machi, Oita, Japan

Journal volume & issue: Vol. 17, no. 9
pp. 3439 – 3445

Abstract

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Large-duct type pancreatic ductal adenocarcinoma (PDA) is a rare morphologic variant forming large duct elements. This case report, to our knowledge, is the first report of a large-duct type PDA with a “honeycomb” appearance resembling a serous cystic neoplasm (SCN) on CT and MRI. The patient is an 82-year-old woman who presented with upper abdominal pain. Dynamic contrast-enhanced CT revealed a multilocular cyst with honeycomb loculi, in which the cyst walls showed gradual enhancement. On T2-weighted MRI, the mass displayed inhomogeneous hyperintensity characterized by a honeycomb appearance with irregular and thick hypointense cyst walls. The patient underwent distal pancreatectomy; histopathological diagnosis was large-duct type PDA. Although the imaging features of large-duct type PDA may resemble those of SCN, this distinction between PDA and SCN is important because the treatment options are very different.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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