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There is a wide variety of solid neoplasms that affect the pancreas. The vast majority of them will be ductal adenocarcinoma and neuroendocrine tumors. MSCT has significantly increased both the detection and improved preoperative staging of pancreatic adenocarcinoma. Volume acquisitions facilitate the creation of high-quality 3D images that provide superior depiction of peripancreatic extension of disease allowing appropriate therapeutic decision making; however pancreas specific multiphase MSCT protocols are required to achieve these results. Additionally, multiphase MSCT has increased the detection of small neuroendocrine tumors. Finally, although there are several much more unusual pancreatic tumors, both primary and secondary that may be infrequently encountered in clinical practice, a more detailed discussion of metastases to the pancreas and non-neoplastic focal pancreatic masses is offered.

The differential diagnosis between chronic pancreatitis (CP) and ductal adenocarcinoma adenocarcinomahas always been a c challenge for imaging. The greatest difficulties regard the following manifestations of CP: Focal forms (“mass forming pancreatitis”, autoimmune pancreatitis, cystic dystrophy of the duodenal wall in the solid variant) Uniform dilatation of the main pancreatic duct (MPD) Cystic masses in CP This chapter will consider the possible semeiotic radiological signs, that, if present allow a correct preoperative diagnosis. For the differential diagnosis of cystic lesions in chronic pancreatitis, please refer to Chapter 16 (Imaging of Pseudocyst).

The retroperitoneum contains the pancreas, kidneys, adrenal glands, ureters, lymph nodes, and great vessels of the abdomen. Most retroperitoneal abnormalities in AIDS patients are not seen in isolation, but rather in combination with findings in other parts of the abdomen or chest, stressing the importance of pattern recognition in attempting to ascribe etiological significance to any given radiological abnormality. The major focus of this chapter will be on the pattern of disease involvement within the abdomen from the viewpoint of analyzing a retroperitoneal abnormality.