Table 1

EUS Criteria For Diagnosis of Chronic Pancreatitis


heterogeneous globular architecture

5-8mm focal areas of reduced echogenicity in the periphery of the gland

increased sharp echogenic foci or bands*

enlargement of the gland

accentuation of lobular architecture

appearance of small cysts or cavities


Pancreatic duct

irregular duct pattern

increasing duct caliber

irregularity of the lumen

visualization of dilated side branches

increased number of side branches*

increased echogenicity of the duct wall*

intraluminal echoes (calculi and protein plugs)

strictures with dilation of the main pancreatic duct

main or branch duct disruption

*Features characteristic of early pancreatitis that are usually appreciated only with EUS 

Table 2

Classification Of Pancreatic Cystic Tumors

Tumors of the exocine pancreas


Serous cystadenoma


Mucinous cystadenoma


Intraductal papillary-mucinous adenoma


Mature cystic teratoma

Borderline (uncertain malignant potential)


Mucinous cystic tumor with moderate dysplasia


Intraductal papillary-mucinous tumor with moderate dysplasia


Solid-pseudopapillary tumor


Ductal adenocarcinoma


Mucinous noncystic carcinoma


Signet ring cell carcinoma


Adenosquamous carcinoma


Undifferentiated (anaplastic) carcinoma


Mixed ductal-endocrine carcinoma


Osteoclast-like giant cell tumor


Serous cystadenocarcinoma


Mucinous cystadenocarcinoma


noninvasive; invasive


Intraductal papillary-mucinous carcinoma (papillary-mucinous carcinoma)


noninvasive; invasive


Acinar cell carcinoma


Acinar cell cystadenocarcinoma


Mixed acinar-endocrine carcinoma




Solid-pseudopapillary carcinoma


Miscellaneous carcinomas


Tumors of the endocrine pancreas

Bengin: Well-differentiated adenoma




Nonfunctioning adenoma

Borderline (uncertain malignant potential)


Well-differentiated nonangioinvasive tumor




Gastrinoma, vipoma, glucagonoma, somatostartinoma, others


Nonfunctioning tumor

Low-grade malignant:

Well to moderately differentiated carcinoma




Gastrinoma, vipomas, glucagonoma, somatostatinoma, others


Nonfunctioning carcinoma

High-grade malignant:

Poorly differentiated carcinoma (ie small cell carcinoma)


Functioning or nonfunctioning

Table 2

Classification of Pancreatic Cystic Tumors

Nonepithelial Tumors

Benign soft tissue tumors

Malignant soft tissue tumors

Malignant lymphomas


Secondary Tumors


Tumor-like Lesions of the Exocrine Pancreas

Chronic pancreatits

Miscellaneous inflammatory changes





Retention cyst


Parasitic cyst


Cogenital cyst


Para-ampullary duodenal wall cyst


Enterogenous cyst


Lymphoepithelial cyst


Endometrial cyst 

Duct changes


Squamous metaplasia


Mucinous cell hypertrophy


Ductal papillary hyperplasia


Adenomatiod ductal hyperplasia


Duct dysplasia

Acinar changes

Heterotopic pancreas

Hetertopic (ectopic) spleen

Hamartoma and pseudotumor

Pseudolipomatous hypertrophy


Islet hyperplasia



Persistent neonatal hyperinsulinemic hypoglycemia


Persistent hyperinsulinemic hypoglycemia in adults