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胰头肿块:肉芽肿性多血管炎的一种罕见表现。

Pancreatic Head Mass: A Rare Manifestation of Granulomatosis With Polyangiitis.

作者信息

Castillo Michael, Gonzalez Adalberto, Ur Rahman Asad, Kaur Jeevna, Bejarano Pablo, Wadhwa Vaibhav, Schneider Alison, Pimentel Ronnie

机构信息

Department of Internal Medicine, Cleveland Clinic Florida, Weston, FL.

Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, Weston, FL.

出版信息

ACG Case Rep J. 2019 Oct 25;6(10):e00263. doi: 10.14309/crj.0000000000000263. eCollection 2019 Oct.

Abstract

Granulomatosis with polyangiitis may rarely present as an inflammatory pancreatic mass and mimic pancreatic cancer. We report a 73-year-old man who presented with fever and weight loss. Computed tomography imaging demonstrated a mass in the pancreatic head along with multiple cavitary pulmonary nodules. Our differential included metastatic pancreatic cancer vs an autoimmune process. Positive cytoplasmic antineutrophil cytoplasmic antibodies coupled with the lung biopsy findings established the diagnosis of granulomatosis with polyangiitis, a very rare cause of pancreatic masses. After completion of immunosuppressive therapy, magnetic resonance imaging demonstrated no evidence of a pancreatic mass. More studies are required to establish the management of these masses.

摘要

显微镜下多血管炎很少表现为炎症性胰腺肿块并酷似胰腺癌。我们报告一例73岁男性,表现为发热和体重减轻。计算机断层扫描成像显示胰头部有一肿块以及多个空洞性肺结节。我们的鉴别诊断包括转移性胰腺癌与自身免疫性疾病。胞浆型抗中性粒细胞胞浆抗体阳性结合肺活检结果确诊为显微镜下多血管炎,这是胰腺肿块的一种非常罕见的病因。免疫抑制治疗完成后,磁共振成像显示无胰腺肿块迹象。需要更多研究来确定这些肿块的处理方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a746/6855549/a5fad2fd58ec/ac9-6-e00263-g001.jpg

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