Yano Masaaki, Nishikawa Masashi, Asai Jun, Urabe Takeshi, Ito Hiroshi
Department of Gastroenterology, Public Central Hospital of Matto Ishikawa.
Nihon Shokakibyo Gakkai Zasshi. 2014 Nov;111(11):2181-9.
A 29-year-old man with ulcerative colitis presented to the hospital complaining of persistent back pain. Pancreatic enzymes and tumor markers were elevated; imaging showed diffuse narrowing of the main pancreatic duct associated with diffuse pancreatic enlargement. We therefore performed an endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) biopsy of the pancreas using a 19-gauge needle. Histopathology revealed interlobular fibrosis, neutrophil infiltration in the intralobular ducts and acini, and very few immunoglobulin G4-positive cells. The patient was diagnosed with type 2 autoimmune pancreatitis and started on oral steroids; subsequently, we observed an improvement in the pancreatic enlargement and duct narrowing. Histologically proven type 2 autoimmune pancreatitis is rare in Japan.
一名29岁的溃疡性结肠炎男性患者因持续背痛入院。胰酶和肿瘤标志物升高；影像学检查显示主胰管弥漫性狭窄并伴有胰腺弥漫性肿大。因此，我们使用19号针进行了内镜超声引导下细针穿刺抽吸（EUS-FNA）胰腺活检。组织病理学显示小叶间纤维化、小叶内导管和腺泡中性粒细胞浸润，以及极少的免疫球蛋白G4阳性细胞。该患者被诊断为2型自身免疫性胰腺炎，并开始口服类固醇治疗；随后，我们观察到胰腺肿大和导管狭窄有所改善。在日本，组织学证实的2型自身免疫性胰腺炎较为罕见。
