Foley Robert W, Redman Stewart L, Graham Richard N, Phull Jaspal S, Masani Vidan, Colleypriest Benjamin J, Little David
Department of Radiology, Royal United Hospital, Bath, United Kingdom.
Department of Urology, Royal United Hospital, Bath, United Kingdom.
BJR Case Rep. 2020 Sep 29;6(2):20190110. doi: 10.1259/bjrcr.20190110. eCollection 2020 Sep.
We describe the case of a gentleman with pleural thickening. On follow-up imaging, dilatation of the main pancreatic and common biliary ducts was noted and an initial diagnosis of pancreatic malignancy was made. During his preoperative workup for pancreatic head malignancy, a PET-CT was performed, which demonstrated increased uptake in the pancreas, in the pleura and in the prostate gland. This raised the possibility of immunoglobulin G4-related disease (IgG4-RD), which was effectively treated with oral steroids. IgG4-RD is a well-described cause of autoimmune pancreatitis but can affect other regions, including the pleura and prostate. It is essential that radiologists are aware of the imaging findings in IgG4-RD and can direct clinicians towards this important multisystem diagnosis.
我们讲述了一位患有胸膜增厚的男性患者的病例。在随访影像检查中，发现主胰管和胆总管扩张，初步诊断为胰腺恶性肿瘤。在他针对胰头恶性肿瘤进行术前检查时，进行了正电子发射断层显像–计算机断层扫描（PET-CT），结果显示胰腺、胸膜和前列腺摄取增加。这增加了免疫球蛋白G4相关疾病（IgG4-RD）的可能性，该疾病通过口服类固醇得到了有效治疗。IgG4-RD是自身免疫性胰腺炎的一个已被充分描述的病因，但可累及其他部位，包括胸膜和前列腺。放射科医生必须了解IgG4-RD的影像学表现，并能够引导临床医生做出这一重要的多系统诊断。
