Department of Radiology, University of California San Diego, San Diego, CA, USA.
Department of Pathology, University of California San Diego, San Diego, CA, USA; Department of Pathology, VA San Diego Healthcare System, San Diego, CA, USA.
Clin Imaging. 2020 Jan;59(1):39-44. doi: 10.1016/j.clinimag.2019.08.006. Epub 2019 Oct 25.
Inflammatory pseudotumors imitate neoplasms on imaging but actually represent focal inflammation. We report a case of follicular pancreatitis, which is a recently recognized distinct form of mass-forming focal chronic pancreatitis pathologically characterized by lymphoid infiltration with abundant reactive germinal centers. In our patient, follicular pancreatitis manifested as a pancreatic tail mass that was resected due to imaging findings, which were suggestive of pancreatic malignancy. We performed a literature review of this rare condition and present a summary of reported imaging findings. The most distinguishing feature from pancreatic adenocarcinoma is the enhancement pattern, as follicular pancreatitis enhances more than the surrounding pancreatic parenchyma on delayed post-contrast images which is unusual for pancreatic adenocarcinoma. If this benign diagnosis is suggested on imaging, unnecessary surgery and its potential complications may be avoided.
炎性假瘤在影像学上酷似肿瘤,但实际上代表局灶性炎症。我们报告了一例滤泡性胰腺炎病例,这是一种新近认识的独特的肿块型胰腺慢性胰腺炎,其病理特征为淋巴样浸润伴丰富反应性生发中心。在我们的患者中,滤泡性胰腺炎表现为胰尾肿块,由于影像学表现提示胰腺恶性肿瘤而进行了切除。我们对这种罕见疾病进行了文献复习,并总结了报道的影像学表现。与胰腺腺癌最显著的区别特征是增强模式,滤泡性胰腺炎在延迟期增强扫描上比周围胰腺实质增强更明显,这在胰腺腺癌中是不常见的。如果影像学上提示这种良性诊断,则可能避免不必要的手术及其潜在并发症。