Solution to Unknown Case # 4 – Pancreatic Psuedocyst

History: Adolescent male with abdominal swelling. This is a pancreatic pseudocyst. A pancreatic pseudocyst is a fluid collection which is surrounded by a fibrous capsule. Pancreatic pseudocysts usually contain pancreatic enzymes, tissue, debris, and sometimes blood. The differential diagnosis for this MRI appearance includes a pancreatic pseudocyst, mucinous cystic pancreatic tumor, pancreatic serous cystadenoma, and…

radiologypics

February 28, 2013

1–2 minutes

abdomen, GI, MRI, pancreas, pediatrics

History: Adolescent male with abdominal swelling.

**Pancreatic Pseudocyst:** Coronal 2D FIESTA (T2 weighted) image of the abdomen reveals a large mass in the left upper quadrant of the abdomen containing T2 hyperintense fluid.

Axial SSFSE (T2 weighted) of the abdomen reveals the fluid containing mass is abutting the left kidney, indicating its likely position in the anterior pararenal space. — **Pancreatic pseudocyst:** Axial SSFSE (T2 weighted) of the abdomen reveals the fluid containing mass is abutting the left kidney, indicating it is likely within the anterior pararenal space.

This is a pancreatic pseudocyst. A pancreatic pseudocyst is a fluid collection which is surrounded by a fibrous capsule. Pancreatic pseudocysts usually contain pancreatic enzymes, tissue, debris, and sometimes blood.

The differential diagnosis for this MRI appearance includes a pancreatic pseudocyst, mucinous cystic pancreatic tumor, pancreatic serous cystadenoma, and much less likely pancreatic intraductal papillary mucinous tumor which are usually multilobulated.

Up to 85% of pancreatic pseudocysts occur in the body and tail of the pancreas, and are usually complications of acute or chronic pancreatitis.

Read about this case of gallstone pancreatitis that developed a large intrapancreatic abscess, or walled off necrosis.