Pancreatic imaging: intraductal papillary mucinous neoplasm: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Pancreatic imaging: intraductal papillary mucinous neoplasm

Sample item

An elderly man has an incidental multilocular pancreatic cystic lesion that communicates with a dilated main pancreatic duct on MRCP, and the ampulla bulges with mucus. What is the likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Intraductal papillary mucinous neoplasm

IPMN arises from the ductal epithelium, communicates with the duct and may produce mucus that gives a fish-mouth papilla. Main duct involvement carries a higher malignant potential. A pseudocyst follows pancreatitis, and a serous cystadenoma does not communicate.

Option by option

  • A. Pancreatic pseudocyst

    A pseudocyst follows an episode of pancreatitis and has a fibrous wall.

  • B. Intraductal papillary mucinous neoplasm (correct)

    Correct. Duct communication with a patulous ampulla indicates IPMN.

  • C. Serous cystadenoma

    Serous cystadenomas are microcystic with a central scar and do not communicate with the duct.

  • D. Solid pseudopapillary neoplasm

    Solid pseudopapillary neoplasms occur in young women and are solid-cystic masses.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Intraductal papillary mucinous neoplasm. IPMN arises from the ductal epithelium, communicates with the duct and may produce mucus that gives a fish-mouth papilla.

Why is "Pancreatic pseudocyst" not the answer?

A pseudocyst follows an episode of pancreatitis and has a fibrous wall.

Why is "Serous cystadenoma" not the answer?

Serous cystadenomas are microcystic with a central scar and do not communicate with the duct.

Why is "Solid pseudopapillary neoplasm" not the answer?

Solid pseudopapillary neoplasms occur in young women and are solid-cystic masses.

What concept does this question test?

It tests Pancreatic imaging: intraductal papillary mucinous neoplasm in Radiology. Main duct involvement carries a higher malignant potential. A pseudocyst follows pancreatitis, and a serous cystadenoma does not communicate.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pancreatic imaging: intraductal papillary mucinous neoplasm?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.