Uchida Kazushige, Satoi Sohei, Miyoshi Hideaki, Hachimine Daisaku, Ikeura Tsukasa, Shimatani Masaaki, Matsushita Mitsunobu, Takaoka Makoto, Takai Soichiro, Ashida Kiyoshi, Okazaki Kazuichi
Third Department of Internal Medicine, Kansai Medical University, Moriguchi.
Intern Med. 2007;46(17):1409-12. doi: 10.2169/internalmedicine.46.6430. Epub 2007 Sep 3.
Recently, it has been reported that autoimmune pancreatitis (AIP) can be complicated with various extrapancreatic lesions. Here, we report a very rare case of pancreatic and hepatic inflammatory pseudotumor (IPT) with the infiltration of IgG4-positive plasmacytes. The patient showed pancreatic and hepatic masses with elevated levels of serum IgG4. Endoscopic retrograde cholangiopancreatography revealed narrowing of the intrapancreatic bile duct. Fluorine-18fluorodeoxyglucose positron emission tomography suggested pancreatic cancer with hepatic metastasis. Histopathologic findings showed fibrosis and infiltration of IgG4-positive plasmacytes, suggesting IPT. The present case suggests a possible common mechanism in the development of AIP and IPT of the liver.
最近，有报道称自身免疫性胰腺炎（AIP）可并发各种胰腺外病变。在此，我们报告一例极为罕见的胰腺和肝脏炎性假瘤（IPT）伴IgG4阳性浆细胞浸润的病例。该患者表现为胰腺和肝脏肿块，血清IgG4水平升高。内镜逆行胰胆管造影显示胰内胆管狭窄。氟-18氟脱氧葡萄糖正电子发射断层扫描提示胰腺癌伴肝转移。组织病理学检查结果显示纤维化及IgG4阳性浆细胞浸润，提示为IPT。本病例提示AIP和肝脏IPT的发生可能存在共同机制。
