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自身免疫性胰腺炎尸检病例

An autopsy case of autoimmune pancreatitis.

作者信息

Kitano Yohei, Matsumoto Kakuya, Chisaka Kenji, Imazawa Masako, Takahashi Kenji, Nakade Yukiomi, Okada Mituyoshi, Aso Kazunobu, Yokoyama Kazunori, Yamamoto Masahiro, Yoshie Masumi, Ogawa Katsuhiro, Haneda Masakazu

机构信息

Second Department of Medicine, Asahikawa Medical College, Asahikawa, Japan.

出版信息

JOP. 2007 Sep 7;8(5):621-7.

Abstract

CONTEXT

Autoimmune pancreatitis is an increasingly recognized type of chronic pancreatitis, but little is known about the long-term outcome of the disease.

CASE REPORT

We report an autopsy case of autoimmune pancreatitis. The patient was an 81-year-old Japanese male. He was referred to our department with jaundice in February 1996. ERCP images revealed a severe stricture of the lower part of the common bile duct and irregular narrowing of the main pancreatic duct. A diagnosis of extrahepatic cholangiocarcinoma was made and endoscopic biliary drainage was performed. A stricture of the common bile duct and narrowing of the pancreatic duct had improved on ERCP images when a follow-up examination was performed in November 1998. He was followed up for chronic pancreatitis. The serum IgG and IgG4 levels were increased on serological examination. He died of interstitial pneumonia and congestive heart failure in May 2003. At the autopsy examination, fibrosis was found in the periductal, interlobular and intralobular parts of the pancreas. Focal atrophy of the acinar cells was also identified. There was little infiltration of inflammatory cells into the parenchyma or the stroma of the pancreas. These pathological findings were similar to those of 'conventional' chronic pancreatitis.

CONCLUSION

We present an autopsy case of autoimmune pancreatitis which is a rare finding.

摘要

背景

自身免疫性胰腺炎是一种日益被认识的慢性胰腺炎类型,但对该疾病的长期预后知之甚少。

病例报告

我们报告一例自身免疫性胰腺炎的尸检病例。患者为一名81岁的日本男性。1996年2月因黄疸转诊至我科。内镜逆行胰胆管造影(ERCP)图像显示胆总管下段严重狭窄及主胰管不规则狭窄。诊断为肝外胆管癌并进行了内镜胆管引流。1998年11月进行随访检查时,ERCP图像显示胆总管狭窄和胰管狭窄有所改善。对其进行慢性胰腺炎随访。血清学检查显示血清IgG和IgG4水平升高。他于2003年5月死于间质性肺炎和充血性心力衰竭。尸检发现胰腺导管周围、小叶间和小叶内有纤维化。还发现腺泡细胞灶性萎缩。胰腺实质或间质中炎症细胞浸润较少。这些病理表现与“传统”慢性胰腺炎相似。

结论

我们报告了一例自身免疫性胰腺炎的尸检病例,这是一个罕见的发现。

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