Ultrasonography (US) renders a direct access to pancreatic morphology. Resolution capabilities of US are not achieved by the secondary imaging modalities (computed tomography and magnetic resonance), and the realtime information in US examination are not available by other modalities either. These unique features of US hold true as well in cystic pancreatic lesions of benign or of malignant origin. Descriptive criteria such as size, number, shape, echogenicity, position, texture, septations and wall structures give valuable information for an as clear a diagnostic classification as possible.
Differential diagnosis of cystic pancreatic lesions by means of US can of course give approximate figures only. Combining all clinical available data immediately with the US findings, however, will usually give a precise diagnosis. The clinical features of the patient’s history, pain absence or presence, overall condition, weight loss etc., will form in the brain of the experienced and caring responsible medical doctor together with the self-made US pictures a precise idea of the given pathology, and the consequences of such a diagnosis. In this exhibit, we will illustrate the US findings and differential diagnosis of various cystic lesions of the pancreas (e.g., pseudocyst, true pancreatic cyst, abscess, benign and malignant cystic neoplasm such as serous cystadenoma, mucinous cystic neoplasms, intraductal papillary-mucinous neoplasms, solid pseudopapillary neoplasms, metastases etc.)and correlate US findings with pathology.