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.
J Gastrointest Surg. 2011 Dec;15(12):2296-8. doi: 10.1007/s11605-011-1543-5. Epub 2011 May 17.
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.
We report a rare case of a patient with focal mass-forming AIP strongly suspected of being PC because of MPD obstruction on ERCP.
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.
自身免疫性胰腺炎(AIP)是一种罕见的疾病,其表现与胰腺癌(PC)非常相似。临床医生必须将两者区分开来,因为它们的治疗和预后有很大的不同。典型的影像学表现,特别是通过内镜逆行胰胆管造影(ERCP)观察弥漫性或节段性狭窄的主胰管(MPD)和不规则的管壁,对于诊断 AIP 是至关重要的。另一方面,MPD 阻塞是 ERCP 上最常见的特征之一。
我们报告了一例罕见的局灶性肿块形成性 AIP 病例,该患者因 ERCP 上的 MPD 阻塞而强烈怀疑为 PC。
目前的诊断方法很难将 PC 与 AIP 区分开来。我们将继续努力区分这两种疾病,以避免不必要的手术。