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Gastroenterology (Expert Forum)
What can cause Pancreas body to be enlarged?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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What can cause Pancreas body to be enlarged?
by seven7, Apr 12, 2003 12:00AM
The question: What, besides cancer and pancreaitus, can cause the pancreas body to be enlarged?
Background information:
I am 69 years old. April 2002 I had a one breast modified radical mastectomy. Since then I have completed 8 chemotherapies (4 Adriamycin/cytoxin, then 4 Taxotere.) Also 33 radiation treatments, and am now on Tamoxifen.
My cancer was Stage 3, with a 50/50 estimate chance of recurrance. I have gotten along real well with all of the treatments.
Two weeks ago I had my year exam: Mammogram, Cat Scan of chest and upper abdoman and a Bone Scan. All of these came through negative, to my delight.
The I found out the puzzler! I was told that the body of my Pancreas was enlarged. I was asked to do another Cat Scan, specifically to look at Pancreas.
Here is what that next report stated:
CT OF PANCREAS WITHOUT COMTRAST: The body of the pancreas is enlarged approximately twice the thickness of the the tail and head of the pancreas. No calcifications seen in the pancreas.
CT PANCREAS WITH INTRAVENOUS CONTRAST: The enhancement of the enlarged portion of the pancreas is homogenous and there is no focal mass within it. There is no pancreatic ductal dilatation or common duct dilatation. The rest of the pancreas is relatively normal. No adjacent adenopathy, fluid collection, or inflammatory changes are seen.
IMPRESSION: Enlarged portion of the body of the pancreas without any definable mass or inflammation. This probably needs to be followed in two to three months with a repeat CT of the pancreas to establish stability."
So, to repeat my question: What could cause this? I naturally am quite concerned about this, being aware of the seriousness of Pancreatic cancer. I do not have any notable symptions of Pancreatic cancer,and I have not lost weight. Seven
Background information:
I am 69 years old. April 2002 I had a one breast modified radical mastectomy. Since then I have completed 8 chemotherapies (4 Adriamycin/cytoxin, then 4 Taxotere.) Also 33 radiation treatments, and am now on Tamoxifen.
My cancer was Stage 3, with a 50/50 estimate chance of recurrance. I have gotten along real well with all of the treatments.
Two weeks ago I had my year exam: Mammogram, Cat Scan of chest and upper abdoman and a Bone Scan. All of these came through negative, to my delight.
The I found out the puzzler! I was told that the body of my Pancreas was enlarged. I was asked to do another Cat Scan, specifically to look at Pancreas.
Here is what that next report stated:
CT OF PANCREAS WITHOUT COMTRAST: The body of the pancreas is enlarged approximately twice the thickness of the the tail and head of the pancreas. No calcifications seen in the pancreas.
CT PANCREAS WITH INTRAVENOUS CONTRAST: The enhancement of the enlarged portion of the pancreas is homogenous and there is no focal mass within it. There is no pancreatic ductal dilatation or common duct dilatation. The rest of the pancreas is relatively normal. No adjacent adenopathy, fluid collection, or inflammatory changes are seen.
IMPRESSION: Enlarged portion of the body of the pancreas without any definable mass or inflammation. This probably needs to be followed in two to three months with a repeat CT of the pancreas to establish stability."
So, to repeat my question: What could cause this? I naturally am quite concerned about this, being aware of the seriousness of Pancreatic cancer. I do not have any notable symptions of Pancreatic cancer,and I have not lost weight. Seven
Doctor's Answer
by Kevin Pho, MD, Apr 14, 2003 12:00AM
, Apr 14, 2003 12:00AM
Hello - thanks for asking your question.
You note a homogenous enlarged portion of the pancreas with no focal mass or inflammation. There are many causes for an enlarged pancreas such as pancreatitis and cancer as you note. Other causes would be a pancreatic pseudocyst or cystadenoma. Other rare possibilities would be a pancreatic anatomic abnormaility (i.e. pancreatic divisum). These causes would show up on the CT or ERCP.
If the enlarged pancreas is an incidental finding in an abdominal CT scan or ultrasound, there are no lesions like masses or cysts, and the pancreatic duct is normal size, it is a normal pancreas.
I agree with the assessment that it should be monitored periodically. If there is enlargement, further studies with an MRI or MRCP/ERCP may be considered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
You note a homogenous enlarged portion of the pancreas with no focal mass or inflammation. There are many causes for an enlarged pancreas such as pancreatitis and cancer as you note. Other causes would be a pancreatic pseudocyst or cystadenoma. Other rare possibilities would be a pancreatic anatomic abnormaility (i.e. pancreatic divisum). These causes would show up on the CT or ERCP.
If the enlarged pancreas is an incidental finding in an abdominal CT scan or ultrasound, there are no lesions like masses or cysts, and the pancreatic duct is normal size, it is a normal pancreas.
I agree with the assessment that it should be monitored periodically. If there is enlargement, further studies with an MRI or MRCP/ERCP may be considered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Member Comments (2)
by seven7, Apr 12, 2003 12:00AM
To: To Doctor from Seven
I forgot to mention that I had a CA 19-9 blood test , and the results of the test have not returned yet.But everywhere I read says that this test is only reliable 50-75% of the time.
by surgeon, Apr 13, 2003 12:00AM
it could be a few things, including just a normal variation; which is what it sounds like. The description that the tissue is homogeneous means it's uniform and not different from the rest of the tissue. Doing a biopsy of the pancreas is a big deal, and it doesn't sound necessary at this point. Repeating the study as suggested sounds very safe, just to document that it's stable. It really doesn't sound like something significant.
