Yoshioka Masato, Shibata Satoshi, Sato Tsutomu, Furuya Tomoki, Asanuma Yoshihiro, Hashimoto Manabu, Koyama Kenji
Department of Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan.
J Hepatobiliary Pancreat Surg. 2002;9(3):376-8. doi: 10.1007/s005340200043.
We report two patients with focal, chronic pancreatitis that was diagnosed by dynamic computed tomography (CT) combined with intraoperative biopsy. In case 1, serum carbohydrate antigen (CA) 19-9 level rose to 160 U/ml. Abdominal ultrasonography, CT, and magnetic resonance imaging demonstrated a mass, of 4.5 cm in diameter, in the pancreatic head. On dynamic CT, the mass was enhanced similarly to the normal pancreatic parenchyma. In case 2, dynamic CT demonstrated a mass, of 3.0 cm in diameter, in the pancreatic head, which was enhanced similarly to the normal pancreatic parenchyma. From such characteristics of enhancement, both masses were suspected to be chronic pancreatitis rather than cancer, and the diagnosis was confirmed by intraoperative biopsy. Three years in case 1 and 2 years in case 2 have passed since their operations, and the size of each mass has not changed. With the use of dynamic CT combined with intraoperative biopsy, focal chronic pancreatitis could be diagnosed more accurately, and this may lead to a reduction in unnecessary pancreatic resection.
我们报告了两名通过动态计算机断层扫描（CT）结合术中活检诊断为局灶性慢性胰腺炎的患者。病例1中，血清糖类抗原（CA）19-9水平升至160 U/ml。腹部超声、CT和磁共振成像显示胰头有一个直径4.5 cm的肿块。在动态CT上，该肿块的强化方式与正常胰腺实质相似。病例2中，动态CT显示胰头有一个直径3.0 cm的肿块，其强化方式与正常胰腺实质相似。根据这种强化特征，两个肿块均怀疑为慢性胰腺炎而非癌症，术中活检证实了诊断。自手术以来，病例1已过去3年，病例2已过去2年，每个肿块的大小均未改变。通过动态CT结合术中活检，可以更准确地诊断局灶性慢性胰腺炎，这可能会减少不必要的胰腺切除术。
