Pancreatic Cyst

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Incidental Pancreatic Cyst


ANY Incidental Pancreatic Cyst in patient >80 y/o

<1.5cm Incidental Pancreatic Cyst

1.5 - 2.5cm Incidental Panc Cyst WITH Main Duct communication

1.5 - 2.5cm Incidental Panc Cyst W/O (or indeterminate) Main Duct communication

>2.5cm Incidental Panc Cyst

ACG Guidelines (Gastroenterology)

"Worrisome Features"

  • Cyst >= 3cm long axis
  • Thickened/enhancing cyst wall
  • Nonenhancing mural nodule
  • Main pancreatic duct >= 7mm at thickest point

"High-Risk Stigmata"

  • Obstructive jaundice with cyst in head of pancreas
  • Enhancing solid component within cyst
  • Main pancreatic duct >=10mm in absence of obstruction

Growth Definition

  • Size <0.5cm: 100% increase in long axis diameter
  • >0.5 and <1.5cm: 50% increase in long axis
  • >1.5cm: 20% increase in long axis

Things to Report

  1. Morphology and location
  2. Size
  3. Possible communication with MPD
  4. Presence of "worrisome features" or "high-risk stigmata"
  5. Growth on f/u exam
  6. Multiplicity

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