Zadeh Jonathan, Andreoni Anthony, Febres-Aldana Christopher, Krishnamurthy Kritika, Kochiyil Jyotsna, Vincentelli Cristina, Ben-David Kfir
Department of Surgery, Mount Sinai Medical Center, Miami Beach, FL, USA.
Department of Pathology, Mount Sinai Medical Center, Miami Beach, FL, USA.
Case Rep Surg. 2020 Feb 6;2020:5021578. doi: 10.1155/2020/5021578. eCollection 2020.
Paraduodenal pancreatitis (PP) is an uncommon abdominal pathology characterized by scarring of the pancreaticoduodenal space. Diagnosis of this inflammatory process is challenging as its clinical presentation is similar to that of pancreatic cancer. Currently, no definitive radiologic or pathologic features have been established to permit diagnosis of PP without surgical resection. However, the presence of eosinophilic concretions has been reported with increasing frequency in the histologic evaluation of PP. To the best of our knowledge, these concretions are distinctive for PP and not reported in neoplasms commonly involving the pancreaticoduodenal space. Herein, we discuss the case of a 60-year-old man who was found to have PP after pancreaticoduodenectomy for a paraduodenal mass with an initially nondiagnostic biopsy. Retrospective review of the preoperative FNA samples revealed eosinophilic concretions like those found in the final surgical specimen. If the identification of eosinophilic concretions in a background of inflammatory changes was to be accepted as a diagnostic criterion for PP, patients such as ours could be spared the morbidity associated with surgical resection.
十二指肠旁胰腺炎（PP）是一种罕见的腹部疾病，其特征为胰十二指肠间隙出现瘢痕形成。由于这种炎症性疾病的临床表现与胰腺癌相似，因此其诊断具有挑战性。目前，尚未确立明确的放射学或病理学特征来允许在不进行手术切除的情况下诊断PP。然而，在PP的组织学评估中，嗜酸性结石的出现频率越来越高。据我们所知，这些结石是PP所特有的，在通常累及胰十二指肠间隙的肿瘤中未见报道。在此，我们讨论一例60岁男性患者的病例，该患者因十二指肠旁肿块接受胰十二指肠切除术后被诊断为PP，其最初的活检结果未能明确诊断。对术前细针穿刺抽吸（FNA）样本的回顾性检查发现了与最终手术标本中相似的嗜酸性结石。如果将在炎症背景下识别嗜酸性结石作为PP的诊断标准，像我们这位患者这样的患者就可以避免手术切除带来的并发症。
