The pancreas is an organ composed of two distinct cellular lines, resulting in exocrine and endocrine compoents. The exocrine glandular epithelium is derived from the gastrointestinal (GI) tract, which also contains two cellular lines: ductal and acinar. The endocrine pancreas is derived from neural crest cells and secretes hormones: thus, it is part of the neuroendocrine system. In addition, connective tissue, neurovascular tissue, and lymphatics are present.
Each component can give rise to neoplasms. In general, benign neoplasms of the pancreas are exceedingly rare (4%). Malignant neoplasms are much more common, and ductal adenocarcinoma is the most common. The clinically relevant pancreatic neoplasms can be categorized by their cell of origin (Table 1).
The purpose of this lesson is to review four of the most common and radiologically interesting pancreatic neoplasms: ductal adenocarcinoma, microcystic adenoma, mucinous cystic neoplasms, and islet cell neoplasms.