Pathways of Regional T Spread in Pancreatic 2 Cancer

Chusilp Charnsangavej, M.D.

Regional spread of pancreatic ductal adenocarcinoma is common at the time of diagnosis, and it is often associated with poor prognosis.1-4 This is because the pancreas is an organ that is located in the retroperitoneum adjacent to many structures and organs, and there is no fibrous capsule or fascial plane to confine the organ. The pathways of regional spread include local organ or structure invasion, perineural spread, vascular invasion, and lymph node metastasis. Diagnosis of regional spread of pancreatic ductal adenocarcinoma is important for surgical planning because the prognosis of patients undergoing pancreatic resection with a positive margin and lymph node metastases is very poor. Conventional imaging modalities such as CT, MR imaging, and ultra-sonography often understage locally advanced disease at pretreatment staging. However, new imaging techniques, such as helical CT with thin-section collimation and fast MR imaging with intravenous dynamic contrast enhancement, have improved the ability to define locally advanced disease.

This chapter defines the pathways of regional spread of pancreatic ductal adenocarcinoma on imaging studies based on the anatomic relationship between the pancreas and its surrounding structures, organs and adjacent blood vessels, lymphatic vessels and nodes, and nerves.

Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

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