Imaging mimics of pancreatic ductal adenocarcinoma

Abdom Radiol (NY). 2018 Feb;43(2):273-284. doi: 10.1007/s00261-017-1330-1.


Pancreatic ductal adenocarcinoma is the most common primary malignancy of the pancreas. The classic imaging features are a hypovascular mass with proximal ductal dilatation. Different pancreatic pathologies can mimic the imaging appearance of carcinoma including other tumors involving the pancreas (pancreatic neuroendocrine tumors, lymphoma, metastasis, and rare tumors like pancreatic acinar cell carcinoma and solid pseudopapillary tumors), inflammatory processes (chronic pancreatitis and autoimmune pancreatitis), and anatomic variants (annular pancreas). Differentiation between these entities can sometimes be challenging due to overlap of imaging features. The purpose of this article is to describe the common entities that can mimic pancreatic cancer on imaging with illustrative examples and to suggest features that can help in differentiation of these entities.

Keywords: Ductal adenocarcinoma; Metastasis; Mimics; Pancreas; Pancreatitis.

Publication types

  • Review

MeSH terms

  • Anatomic Variation
  • Autoimmune Diseases / diagnostic imaging
  • Carcinoma, Pancreatic Ductal / diagnostic imaging*
  • Diagnosis, Differential
  • Humans
  • Pancreas / abnormalities
  • Pancreas / diagnostic imaging
  • Pancreatic Diseases / diagnostic imaging
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatitis / diagnostic imaging

Supplementary concepts

  • Annular pancreas