[Lymphoplasmacytic sclerosing pancreatitis: a case report]

The Authors report a case of a 57 years old woman with a pancreatic cystic mass detected by abdominal ultrasonography performed for abdominal pain. Abdominal computed tomography revealed a cystic mass in the pancreatic head. Left segmental intrahepatic biliary tract dilatation without dilatation of the common bile duct and dilatation of the main pancreatic duct distal to the pancreatic mass were also present at cholangio-pancreatography. The patient underwent pancreaticoduodenectomy (Whipple procedure). The histological diagnosis was lymphoplasmacytic pancreatitis. The diagnosis of this disease is challenging. It should be suspected in patients with known autoimmune diseases. Accepted diagnostic criteria are diffuse swelling of the pancreas and diffuse or focal narrowing of the main pancreatic duct, but they are not always present. In the absence of the above-mentioned characteristics, when the disease presents as a solid or, less frequently, cystic mass it is almost impossible to distinguish it from pancreatic neoplasms. Awareness of this pathological condition in the differential diagnosis of pancreatic masses is necessary, especially in view of reports of complete recovery after medical therapy in the literature.