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Autoimmune pancreatitis with multifocal lesions.
Masatoshi Kajiwara1, Motohiro Kojima, Masaru Konishi
1Department of Hepatobiliary Pancreatic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
Journal of Hepato-Biliary-Pancreatic Surgery
|August 2, 2008
Summary
Autoimmune pancreatitis (AIP) can present as focal lesions mimicking pancreatic cancer. Early differentiation is crucial for effective steroid treatment, avoiding unnecessary surgery.
Area of Science:
- Gastroenterology
- Pathology
- Radiology
Background:
- Autoimmune pancreatitis (AIP) is an immune-mediated pancreatic disease.
- Focal AIP can mimic pancreatic cancer, presenting diagnostic challenges.
Observation:
- Two cases of focal AIP with distinct double pancreatic mass lesions are presented.
- Imaging (CT, MRCP, FDG-PET) revealed localized masses and main pancreatic duct stenosis.
- Histology confirmed lymphoplasmacytic infiltration, not malignancy.
Findings:
- Focal AIP can present as multiple pancreatic lesions.
- Elevated serum IgG4 levels were observed postoperatively.
- Histopathological analysis ruled out malignancy in both cases.
Implications:
- Accurate differentiation of focal AIP from pancreatic cancer is clinically vital.
- Prompt diagnosis allows for steroid therapy, improving patient outcomes.
- Recognition of multifocal AIP presentation aids in diagnosis.
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