pancreatic calcification

Pancreatic calcifications can arise from many etiologies.

Punctate intraductal calcifications
Smaller intraductal calcifications
  • senile 
    • usually in patients aged over 70 years
    • scattered
    • number of calcifications increase with age
  • cystic fibrosis: finely granular calcifications in smallest ducts in end stage disease with pancreatic failure
  • atherosclerotic calcifications
  • chronic pancreatitis
Larger intraductal calcifications
Dystrophic calcification
  • old insult
    • old infection
    • old infarction
    • old trauma
  • pancreatic tumors
    • islet cell tumors: especially non-functional tumors; 20% islet cell tumors
    • calcified metastasis
      • colon
      • renal
    • cystic pancreatic neoplasms
      • mucinous (macrocystic) cystadenomas and carcinomas: mucus in tumor rarely calcifies; cysts >2 cm
      • serous (microcystic) cystadenomas and carcinomas: commonly calcify, characteristically as a central calcified scar with radiating calcified septations
      • intraductal papillary mucinous neoplasms: widened pancreatic duct extensive mucus
      • solid and pseudopapillary epithelial neoplasm
        • rare: in young women. commonly calcifies.  characteristically punctate, peripheral calcifications.
      • pancreatoblastoma: rare. ~ 20% calcify
      • cavernous lymphangioma / hemangioma (multiple phleboliths) 

Note: adenocarcinomas of the pancreas do not generally calcify; rather, they typically engulf previously present adjacent calcifications.

Pancreatic calcification mimics
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