Localized necrotizing arteritis. A report of two cases involving the gallbladder and pancreas

We report two cases of localized necrotizing arteritis, one involving the gallbladder and one involving the pancreas. Both cases were found incidentally in surgically resected specimens. Vascular changes in both cases were similar to those seen in classic polyarteritis nodosa, involving medium-sized muscular arteries characterized by fibrinoid necrosis and panarterial and periarterial inflammations varying from active to resolving stages. Both patients had no constitutional symptoms or underlying serologic abnormalities suggestive of systemic angitis. To our knowledge, pancreas-limited arteritis has not previously been described. Whether these lesions represent an early manifestation of a systemic arteritides syndrome, a variant of polyarteritis nodosa, or a distinct entity should be prudently judged through a long-term follow-up.