Diffuse Pancreatic Cancer Mimicking Autoimmune Pancreatitis
Diffuse Pancreatic Cancer Mimicking Autoimmune Pancreatitis
复制标题
DOI：
10.2169/internalmedicine.2689-19
复制
发表时间：
2019-01-01
影响因子：
1.2
通讯作者：
Okazaki, Kazuichi
中科院分区：
文献类型：
--
作者：
Miyoshi, Hideaki;Kano, Masataka;Okazaki, Kazuichi
肠状胰腺或囊状胰腺边缘的特征性表现有助于自身免疫性胰腺炎的诊断。我们在此报告一个67岁的男性病例，在计算机断层扫描上显示香肠状，胰腺肿大，边缘呈囊状。此外，内窥镜逆行胆管造影显示除了下胆管狭窄外，主胰管弥漫性狭窄。最后，我们在经口胆管镜检查和胆汁细胞学检查后，通过内镜超声引导下的细针穿刺活检诊断出该患者的胰腺癌。本报告强调在开始治疗前进行病理确认的重要性，即使在弥漫性胰腺肿大的病例中也是如此。
The characteristic finding of sausage-shaped pancreas or capsule-like rim facilitates the diagnosis of autoimmune pancreatitis. We herein report a case of a 67-year-old man showing a sausage-shaped, enlarged pancreas with a capsule-like rim on computed tomography. Furthermore, endoscopic retrograde cholangiopan-creatography demonstrated diffuse narrowing of the main pancreatic duct, in addition to stenosis of the lower bile duct. Finally, we were able to diagnose pancreatic cancer in this patient by an endoscopic ultrasound-guided fine-needle aspiration biopsy following peroral cholangioscopy and bile cytology. This report emphasizes the significance of pathological confirmation before starting treatment, even in cases with diffuse pancreatic enlargement.