Innovations in macroscopic evaluation of pancreatic specimens and radiologic correlation Charikleia Triantopoulou, Kleo Papaparaskeva, Christos Agalianos,

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Innovations in macroscopic evaluation of pancreatic specimens and radiologic correlation Charikleia Triantopoulou, Kleo Papaparaskeva, Christos Agalianos, Christos Dervenis European Journal of Radiology Open Volume 3, Pages 49-59 (January 2016) DOI: 10.1016/j.ejro.2016.02.001 Copyright © 2016 Terms and Conditions

Fig. 1 Circumferential resection margins in a pancreatoduodenectomy specimen: anterior surface (red) (a), facing the SMV (green) (a), facing the SMA (yellow) (a,b) and posterior surface(blue) (b). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.) European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 2 After axial slicing of a pancreatoduodenectomy specimen, the slices are arranged in sequential order. To allow optimal correlation with preoperative imaging, they are arranged from cranial to caudal. European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 3 Radiologic-pathologic correlation of a hypovascular mass in the anterior aspect of the pancreatic head on contrast enhanced CT (yellow arrow). Cystic part of a solid tumor is also evident (blue arrow). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.) European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 4 Radiologic-pathologic correlation of an isoattenuating pancreatic adenocarcinoma on contrast enhanced CT due to fibrosis. Dilated pancreatic duct (blue arrow) and common bile duct (yellow arrow) are also evident. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.) European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 5 Radiologic pathologic correlation of a large exophytic and partially necrotic duodenal GIST adjacent to the pancreatic head that was intact and displaced. European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 6 Tiny cystic areas inside a ductal adenocarcinoma are recognized and correlated on CT images and histopathology (blue arrows). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.) European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 7 Microcystic serous adenoma: typical sponge-like appearance of a large microcystic lesion perfectly correlated on T2-w MR image and macroscopic evaluation. European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 8 Macrocystic serous adenoma: the large cystic spaces and the thin septa are evident in this well-defined benign cystic lesion on contract enhanced CT and macroscopy. European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 9 A mucinous cystic neoplasm is shown, presenting a fibrotic area (blue arrow) and no evidence of adenocarcinoma (a) in the macroscopic evaluation. Microscopically (b: H/EX200) an associated invasive carcinoma of less than 0.5cm in size behind the fibrotic area was revealed (yellow arrow). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.) European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 10 MRI-pathologic correlation of a small hypervascular neuroendocrine tumor in the periampullary area. European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 11 A rare pancreatic head hypervasccular paragaglioma showing marked heterogeneity was revealed in a patient suffering from Hirschsprung’s disease. European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 12 Nice depiction and correlation of the duodenum (blue arrow), the markedly dilated CBD (red arrow) and the less dilated MPD (yellow arrow) (a). A very small ampullary adenocarcinoma was found that was missed by imaging (red arrow in b). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.) European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 13 The fibrotic and hyperplastic ampulla was misinterpreted as a tumor on imaging (blue arrow in a). A small duodenal NETG1, just above the fibrotic ampulla, was revealed on histopathology (blue arrow in b). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.) European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 14 A large periampullary tumor (blue arrow) together with an intraductal papillary mucinous neoplasm (IPMN) in the uncinate process (yellow arrow) is evident. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.) European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 15 A misleading case of post inflammatory fibrosis presenting as markedly thickened wall of the distal common bile duct. European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions

Fig. 16 A borderline resectable tumor on contrast enhanced CT before and after treatment (a). The radiologic-pathologic correlation of the specimen with evident post treatment changes adjacent to superior mesenteric artery (blue arrows in b). (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.) European Journal of Radiology Open 2016 3, 49-59DOI: (10.1016/j.ejro.2016.02.001) Copyright © 2016 Terms and Conditions