Franchello Alessandro, Gonella Federica, Campra Donata, Limerutti Giorgio, Bruno Mauro, De Angelis Claudio, Cassine Davide, Fronda Gianruggero, Silvestri Stefano
Department of Surgery, Molinette Hospital, Turin, Italy.
Department of Surgery, Molinette Hospital, Turin, Italy.
Int J Surg Case Rep. 2014;5(12):1095-7. doi: 10.1016/j.ijscr.2014.11.014. Epub 2014 Nov 11.
Autoimmune pancreatitis (AIP) is a rare pancreatic disorder among chronic pancreatitis that can mimick pancreatic cancer (PC). Patients with type 1 AIP usually present obstructive jaundice associated with high level of IgG4 in serum and a pancreatic mass at radiological imaging; these disorders may be associated with other organs lesions presenting the same histopathological features, and in these cases AIP should be considered a pancreatic localization of an IgG4-related systemic disease.
We report the case of a young man with initial suspect of PC to be treated with surgery, and final diagnosis of AIP in the context of an IgG4-related systemic disease.
Because of its similar features, several algorithms have been proposed for AIP diagnosis, based on combination of clinical/serological and radiological criteria. However, histology represents the only way to obtain definitive diagnosis, even if sometimes it is difficult to obtain biological samples.
IgG4-related systemic disease must be taken into account among differential diagnosis during the workup for PC, in order to avoid unnecessary surgery.
自身免疫性胰腺炎（AIP）是慢性胰腺炎中一种罕见的胰腺疾病，可酷似胰腺癌（PC）。1型AIP患者通常表现为梗阻性黄疸，血清IgG4水平升高，影像学检查显示胰腺肿块；这些疾病可能与呈现相同组织病理学特征的其他器官病变相关，在这些情况下，AIP应被视为IgG4相关系统性疾病的胰腺定位。
我们报告了一名年轻男性的病例，最初怀疑为PC并拟行手术治疗，最终诊断为IgG4相关系统性疾病背景下的AIP。
由于其特征相似，基于临床/血清学和影像学标准的组合，已提出了几种用于AIP诊断的算法。然而，组织学是获得明确诊断的唯一方法，即使有时难以获取生物样本。
在PC的检查过程中，鉴别诊断时必须考虑IgG4相关系统性疾病，以避免不必要的手术。
