What are the sonographic features of pancreatic adenocarcinoma?
Most commonly, pancreatic adenocarcinoma appears sonographically as an ill-defined, hypoechoic pancreatic mass. Dilation of the main pancreatic duct upstream to the mass is also commonly seen. When the mass is located in the pancreatic head, both the main pancreatic duct and the extrahepatic bile duct may be dilated (the “double-duct” sign), which is an ominous indication of an obstructive pancreatic adenocarcinoma.
The differential diagnosis for a focal hypoechoic pancreatic mass includes focal pancreatitis, peripancreatic lymph nodes, ampullary carcinoma, pancreatic lymphoma, and metastatic disease to the pancreas.