Coenen Sandra, Welling Lieke, de Schryver Anneke M P, Laméris Johan S, Schipper D Lucette, van Gulik Thomas M
Jeroen Bosch Ziekenhuis, Afd. Maag-, Darm- en Leverziekten, Den Bosch, the Netherlands.
Ned Tijdschr Geneeskd. 2011;155(35):A3067.
Three male patients aged between 50 and 70 years were referred with jaundice and weight loss. Imaging showed a pancreatic mass and changes in the calibre of the choledochal or pancreatic duct, suggestive of malignancy. Two patients were operated on. One patient was considered to have an unresectable carcinoma but showed remarkable clinical improvement after steroids were given for his poor condition. In the other patient a resection was performed. Histology showed IgG4-positive plasma cell infiltration without signs of malignancy. Eventually these patients were diagnosed with auto-immune pancreatitis (AIP). In the third patient AIP was considered beforehand and this patient was treated with steroids. He responded quickly both clinically and radiologically. CT imaging showed complete remission of the mass. AIP is a benign inflammatory process which can mimic pancreatic carcinoma. In doubtful cases, a short trial of steroids might be considered.
三名年龄在50至70岁之间的男性患者因黄疸和体重减轻前来就诊。影像学检查显示胰腺有肿块，胆总管或胰管管径改变，提示恶性病变。两名患者接受了手术。一名患者被认为患有无法切除的癌症，但在因身体状况不佳给予类固醇治疗后，临床症状有显著改善。另一名患者进行了切除手术。组织学检查显示IgG4阳性浆细胞浸润，无恶性迹象。最终，这些患者被诊断为自身免疫性胰腺炎（AIP）。第三名患者事先被考虑患有AIP，该患者接受了类固醇治疗。他在临床和影像学方面均迅速起效。CT成像显示肿块完全消退。AIP是一种可模仿胰腺癌的良性炎症过程。在可疑病例中，可考虑进行短期类固醇试验。
