A case study of solid cystic tumor of the pancreas with no cystic area, including usefulness of color doppler flow imaging, CO₂ angiography and intraductal ultrasonography of the pancreas

A case of a solid cystic tumor of the pancreas with no cystic area in a 45-year-old woman is reported. Endoscopic ultrasonography showed spotted high echo in a hypoechoic mass with partially unclear margin in the body of the pancreas. Intraductal ultrasonography of the pancreas showed a hypoechoic mass with central echogenic area and peripheral aechoic area. Color doppler flow imaging showed color in the rim of the mass. CO₂ angiography showed the mass with enhancement from the rim to the center in early phase and with retention of enhancement of the rim and the center of the mass in late phase. Pathological sections showed the small tumor (25 X 20 X 20mm in diameter) composed solid area with no cystic area. The tumor in the microscopic features exhibited pseudopapillary structures and invaded into the normal pancreas tissue. The vessels in the tumor spread from the rim to the center. Immunological staining for alpha-1-antitrypsin, chymotrypsin and non-specific enolase showed positive tumor cells.