pancreatic calcification


Pancreatic calcifications can arise from many etiologies.
Punctate intraductal calcifications
- chronic pancreatitis
- alcoholic pancreatitis (20-40%)
- intraductal, numerous, small, irregular
- preponderant cause of diffuse pancreatic intraductal calcification
- gallstone pancreatitis (2%)
- much less commonly associated with calcifications
- hyperparathyroidism (10%)
- most also have nephrocalcinosis or urolithiasis (70%)
- alcoholic pancreatitis (20-40%)
- kwashiorkor
- calcifications are common
- manifest in the pediatric population
- hemochromatosis
- idiopathic: no underlying cause can be determined
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
- hereditary pancreatitis
- autosomal dominant 9% penetrance
- large rounded shape
- peaks at 5-17 years
- chronic pancreatitis
- gallstone migration
- tropical pancreatitis: young patients in tropical countries
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
- atherosclerosis of splenic artery and intrapancreatic arterioles
- oral contrast in duodenal diverticula
Siehe auch:
- Chronische Pankreatitis
- zystische Fibrose
- Insulinom
- solider pseudopapillärer Tumor des Pankreas
- intraduktale papillär muzinöse Neoplasie
- Verkalkungen Arteria lienalis
- Pankreatoblastom
und weiter:
