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CT and Pathologic Assessment of Prospective Nodal Staging in Patients with Ductal Adenocarcinoma of the Head of the Pancreas

Clare J. Roche1, Mark L. Hughes1, Conall J. Garvey1, Fiona Campbell2, Donagh A. White1, Lucie Jones3 and John P. Neoptolemos3

1 Department of Radiology, Royal Liverpool University Hospital, Prescot St., Liverpool, L7 8XP, United Kingdom.
2 Department of Pathology, Royal Liverpool University Hospital, Liverpool, L7 8XP, United Kingdom.
3 Department of Surgery, Royal Liverpool University Hospital, Liverpool, L7 8XP, United Kingdom.



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  		Fig. 1. —Diagram shows Japan Pancreas Society [13] nodal group locations in pancreatic cancer. Node classifications and corresponding locations are detailed in Table 1. SMV = superior mesenteric vein, SMA = superior mesentric artery.

 


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  		Fig. 2. —73-year-old man with pancreatic ductal adenocarcinoma. CT scan shows round 12-mm node (arrow) anterior to common hepatic artery (Japan Pancreas Society [13] group 8a). Histologic findings showed ductal adenocarcinoma metastases in this node

 


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  		Fig. 3. —78-year-old woman with pancreatic ductal adenocarcinoma. CT scan shows ovoid 7-mm node (Japan Pancreas Society [13] group 8a, thick arrow) anterior to common hepatic artery and 6-mm node (Japan Pancreas Society group 13a, thin arrow) behind pancreatic head. Both were proven to be metastatic nodes.

 

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