ObjectiveTo explore the features that predict size increase and development of potential malignant features in incidentally detected, unilocular cystic pancreatic lesions (CPLs) less than 3 cm in diameter, during subsequent follow-up.Materials and MethodsWe retrieved data of patients diagnosed with unilocular CPLs less than 3 cm in diameter during the period from November 2003 through December 2014, using a computerized search. All serial CT and MR images were analyzed to identify the number, size, and location of CPLs; dilatation of the main pancreatic duct; and occurrence of worrisome features and high-risk stigmata of malignancy in the lesion. The characteristics of CPLs were compared between the increase (i.e., size increase during subsequent follow-up) and no-increase groups. For CPLs in the increase group, subgroup analysis was performed according to the lesion size at the last follow-up (< 3 cm vs. ≥ 3 cm).ResultsAmong 553 eligible patients, 132 (23.9%) had CPLs that increased in size, and 421 (76.1%) had CPLs that did not, during follow-up. Of the 132, 12 (9.1%) CPLs increased to diameters ≥ 3 cm at the final follow-up. Among the various factors, follow-up duration was a significant independent factor for an interval size increase of CPLs (p < 0.001). In the increase group, initial cyst size was a significant independent factor to predict later size increase to or beyond 3 cm in diameter (p < 0.001), and the initial cyst diameter ≥ 1.5 cm predicted such a growth with a sensitivity and specificity of 83% and 72%, respectively. No significant factors to predict the development of potential malignant features were identified.ConclusionFollow-up duration was associated with an interval size increase of CPLs. Among the growing CPLs, initial cyst size was associated with future lesion growth to and beyond 3 cm.
Purpose: To investigate radiologic findings of intraosseous lipoma on plain radiograph and magnetic resonance imaging (MRI). Materials and Methods: Twenty-seven radiologically or pathologically confirmed intraosseous lipomas of long bones were included in the study. The size, involved bone and site, bone destruction pattern, border, internal calcification, bony expansion, cortical disruption and endosteal erosion were retrospectively analyzed on plain radiograph. The cases were classified into three stages based on calcification and cystic change. Eccentricity, margin, signal intensity of internal fatty portion, and presence of enhancement were analyzed. Results: Twelve tumors were located in femur and 8 in humerus. Proximal metaphysis was the most common involved site, with 14 cases. All tumors had geographic bone destruction, with sclerotic rim in 18 cases on plain radiograph. Internal calcification was seen in 18 cases and bony expansion in 6 cases. Twenty-three cases had cystic change in MRI. Eleven cases had eccentric location. The margins were well-defined in 11 cases. High signal intensity of fatty portion on fat-sat T2-weighted image was present in 17 cases. Contrast enhancement was seen in 17 cases. Conclusion: Knowledge of plain radiographic and MRI findings of intraosseous lipoma of long bones is valuable to the tumor diagnosis differentiation from other bone lesions.
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