– Others types more heterogeneous (or even cystic)
– Overlying mucosa of bowel often avidly enhancing
• MR findings: Ectopic pancreas is isointense on all pulse sequences with main pancreas (including DWI/ADC)
TOP DIFFERENTIAL DIAGNOSES
• Gastric GIST
• Other gastric hypervascular submucosal lesions (glomus tumor, carcinoid, GIST)
• Gastric ulcer
• Gastric carcinoma
• Gastric metastases and lymphoma
CLINICAL ISSUES
• Most patients are asymptomatic and ectopic pancreas is usually an incidental finding
• Can be complicated by bleeding or mucosal ulceration and patients present with epigastric pain and melena
• Can undergo any of the inflammatory or neoplastic abnormalities of main pancreas including acute/chronic pancreatitis and development of malignancy
(Left) Axial CECT demonstrates a mural mass in the body of the stomach. Note that the mass enhances similarly to the normal pancreas. Endoscopic biopsy revealed ectopic pancreatic tissue.
(Right) Axial CECT in a patient with abdominal pain demonstrates a cystic intramural mass within the distal stomach, found to represent ectopic pancreas after surgery. Ectopic pancreas can appear homogeneous, heterogeneous, or cystic depending on its internal mixture of acini, ducts, and islet cells.
(Left) Upper GI series spot film shows a small antral mass with intact mucosa. A central “dot” of barium can be seen filling a rudimentary duct.
(Right) Upper GI image shows a small, smooth, intramural mass along the greater curvature of the antrum without central umbilication. Only 45% of patients with ectopic pancreas will have central umbilication on a barium study. In the absence of this sign, it is difficult to distinguish ectopic pancreas from other intramural masses, such as metastasis or GIST.
in the body of the stomach. Note that the mass enhances similarly to the normal pancreas. Endoscopic biopsy revealed ectopic pancreatic tissue.
within the distal stomach, found to represent ectopic pancreas after surgery. Ectopic pancreas can appear homogeneous, heterogeneous, or cystic depending on its internal mixture of acini, ducts, and islet cells.
can be seen filling a rudimentary duct.
along the greater curvature of the antrum without central umbilication. Only 45% of patients with ectopic pancreas will have central umbilication on a barium study. In the absence of this sign, it is difficult to distinguish ectopic pancreas from other intramural masses, such as metastasis or GIST.
