A Focal Mass-Forming Autoimmune Pancreatitis Mimicking Pancreatic Cancer with Obstruction of the Main Pancreatic Duct

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• 作者：Ippei Matsumoto (1)
  Makoto Shinzeki (1)
  Hirochika Toyama (1)
  Sadaki Asari (1)
  Tadahiro Goto (1)
  Isamu Yamada (1)
  Tetsuo Ajiki (1)
  Takumi Fukumoto (1)
  Yonson Ku (1)
  
• 关键词：Autoimmune pancreatitis ; Pancreatic cancer ; Endoscopic retrograde cholangiopancreatography ; Main pancreatic duct ; Diagnosis
• 刊名：Journal of Gastrointestinal Surgery
• 出版年：2011
• 出版时间：December 2011
• 年：2011
• 卷：15
• 期：12
• 页码：2296-2298
• 全文大小：110KB
• 参考文献：1. Okazaki K, Kawa S, Kamisawa T et al. Clinical diagnostic criteria of autoimmune pancreatitis: revised proposal. J Gastroenterol 2006; 41: 626鈥?31. CrossRef
  2. Wolfson D, Barkin JS, Chari ST et al. Management of pancreatic masses. Pancreas 2005; 31: 203鈥?17. CrossRef
  3. Kamisawa T, Imai M, Yui Chen P et al. Strategy for differentiating autoimmune pancreatitis from pancreatic cancer. Pancreas 2008; 37: e62鈥?7 CrossRef
  4. Chang WI, Kim BJ, Lee JK et al. The clinical and radiological characteristics of focal mass-forming autoimmune pancreatitis: comparison with chronic pancreatitis and pancreatic cancer. Pancreas 2009; 38: 401鈥?08. CrossRef
  5. Horiuchi A, Kawa S, Hamano H et al. ERCP features in 27 patients with autoimmune pancreatitis. Gastrointest Endosc 2002; 55: 494鈥?99.
  6. Wakabayashi T, Kawaura Y, Satomura Y et al. Clinical and imaging features of autoimmune pancreatitis with focal pancreatic swelling or mass formation: comparison with so-called tumor-forming pancreatitis and pancreatic carcinoma. Am J Gastroenterol 2003; 98: 2679鈥?687. CrossRef
  7. Nishino T, Oyama H, Toki F, Shiratori K. Differentiation between autoimmune pancreatitis and pancreatic carcinoma based on endoscopic retrograde cholangiopancreatography findings. J Gastroenterol 2010; 45: 988鈥?96. CrossRef
  8. Ghazale A, Chari ST, Smyrk TC et al. Value of serum IgG4 in the diagnosis of autoimmune pancreatitis and in distinguishing it from pancreatic cancer. The American journal of gastroenterology 2007; 102: 1646鈥?653. CrossRef
  9. Inoue H, Miyatani H, Sawada Y, Yoshida Y. A case of pancreas cancer with autoimmune pancreatitis. Pancreas 2006; 33: 208鈥?09. CrossRef
  10. Witkiewicz AK, Kennedy EP, Kennyon L et al. Synchronous autoimmune pancreatitis and infiltrating pancreatic ductal adenocarcinoma: case report and review of the literature. Hum Pathol 2008; 39: 1548鈥?551. CrossRef
  
• 作者单位：Ippei Matsumoto (1)
  Makoto Shinzeki (1)
  Hirochika Toyama (1)
  Sadaki Asari (1)
  Tadahiro Goto (1)
  Isamu Yamada (1)
  Tetsuo Ajiki (1)
  Takumi Fukumoto (1)
  Yonson Ku (1)
  
  1. Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
  

文摘

Introduction and background Autoimmune pancreatitis (AIP) is a rare disease that closely mimics pancreatic cancer (PC) in its presentation. It is very important for clinicians to distinguish one from the other because their treatment and prognosis are vastly different. Typical radiological imaging findings, in particular observation of diffusely or segmentally narrowed main pancreatic duct (MPD) with an irregular wall by endoscopic retrograde cholangiopancreatography (ERCP), are essential for making the diagnosis of AIP. On the other hand, MPD obstruction is one of the most frequent features on ERCP. Case report We report a rare case of a patient with focal mass-forming AIP strongly suspected of being PC because of MPD obstruction on ERCP. Conclusion It was difficult to distinguish PC from AIP with current diagnostic modalities. We will continue to make an effort to distinguish between the two disorders to prevent unnecessary surgery.