Philips Cyriac Abby, Augustine Philip, Joseph George, Kumar Lijesh, Mahadevan Pushpa
Associate Director, Department of Hepatology and Liver Transplant Medicine, PVS Institute of Digestive Diseases, Kochi, Kerala, India.
Chairman, Department of Gastroenterology, PVS Institute of Digestive Diseases, Kochi, Kerala, India.
J Clin Diagn Res. 2017 Aug;11(8):OD03-OD04. doi: 10.7860/JCDR/2017/27421.10386. Epub 2017 Aug 1.
A 39-year-old woman is admitted with clinical, biochemical and imaging features suggestive of acute pancreatitis. Conservative and guideline based management failed to improve her condition. Repeate the imaging utilizing contrast revealed the progression of extra-pancreatic signs in the absence of pancreatic necrosis, the absence of intra-abdominal fluid collections, but enhancing omental and peritoneal deposits and obstructive pancreatitis. A biopsy and histopathological evaluation of the omentum revealed rare anaplastic large cell lymphoma causing obstructive pancreatitis. In patients who present with pancreatitis not responding to conventional treatment and with an atypical disease course, the diagnostic possibility of rare causes of pancreatitis such as obstructive/infiltrative pathology must be thought of.
一名39岁女性因具有提示急性胰腺炎的临床、生化及影像学特征而入院。基于指南的保守治疗未能改善其病情。使用造影剂重复进行影像学检查显示,在无胰腺坏死、无腹腔积液的情况下,胰腺外体征进展,但网膜和腹膜有强化沉积物及梗阻性胰腺炎。网膜活检及组织病理学评估显示为罕见的间变性大细胞淋巴瘤导致梗阻性胰腺炎。对于出现对常规治疗无反应且病程不典型的胰腺炎患者,必须考虑到胰腺炎罕见病因如梗阻性/浸润性病变的诊断可能性。