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Updated: Aug 11, 2025
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Published on: August 19, 2017
Follicular pancreatitis: Case report and literature review
Wan-Sik Lee1, Ki-Hyun Kim1, Myung-Giun Noh2
1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Rationale:
Follicular pancreatitis is a very rare type of focal chronic pancreatitis and is often mistaken for pancreatic neoplasms. It is histologically characterized by extensive lymphoid follicular formation with reactive germinal centers.
Patient Concerns:
A 50-year-old man was admitted to our hospital with 1-month history of epigastric pain. Contrast-enhanced computed tomography and magnetic resonance imaging revealed a 4.7 cm sized enhancing pancreatic head mass with anterior mesenteric soft tissue infiltration and superior mesenteric vein invasion. Endoscopic ultrasonography revealed an ill-defined hypoechoic mass in the head of the pancreas.
Diagnoses:
A laparoscopic surgical biopsy was performed. Hematoxylin-eosin staining showed the acini structure destruction within the pancreatic parenchyma and different-sized lymphoid follicles with reactive germinal centers around the duct. Immunohistochemical examination showed that cells were positive for the B-cell marker CD20, T-cell marker CD3, and slightly positive for IgG4. However, cells were negative for the B-cell marker Bcl-2. Follicular pancreatitis was confirmed based on the findings of histology and immunohistochemistry.
Interventions:
The patient was regularly followed without any specific treatment.
Outcomes:
Follow-up computed tomography revealed no change in the lesion 1 year after diagnosis.
Lessons:
To the best of our knowledge, this is the first case of follicular pancreatitis in Korea.
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