Autoimmune pancreatitis diagnosed preoperatively with pancreatic ductal cancer: a case report

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  • 膵癌の合併が疑われた自己免疫性膵炎の１例

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A 64-year-old man was referred to our hospital for further investigation of a lesion at the pancreatic body. CT showed swelling of the whole pancreas and a poorly enhanced area in the tail, but did not reveal a lesion in the body. A high IgG4 value and positive anti-nuclear antibody were found serologically. EUS detected a low echoic lesion with an irregular surface (about 15mm in the diameter) at the body. Contrast-enhanced ultrasonography revealed a hypovascular lesion at the body. ERCP showed a segmental stricture of the MPD at the portion of the pancreatic body and abnormal epithelial cells were detected in biopsy specimens. A diagnosis of autoimmune pancreatitis (AIP) with pancreatic ductal cancer was made, and distal pancreatectomy and cholecystectomy were performed. Histopathological examination revealed severe fibrosis and inflammatory cell infiltration in the whole resected pancreas and these cells showed positive staining for IgG4, but there were no malignant findings. We clinically diagnosed AIP. This is a case report of autoimmune pancreatitis in which we could not exclude pancreatic ductal cancer in the body.<br>

Journal

  • Suizo

    Suizo 22 (4), 479-487, 2007

    Japan Pancreas Society

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