Lin Zi-Qi, Li Xin, Yang Yan, Wang Yi, Zhang Xiao-Ying, Zhang Xiao-Xin, Guo Jia
Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Centre and West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
Laboratory Medicine, West China School of Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Clin Cases. 2022 May 26;10(15):4886-4894. doi: 10.12998/wjcc.v10.i15.4886.
Nonfunctional pancreatic neuroendocrine tumours are difficult to diagnose in the early stage of disease due to a lack of clinical symptoms, but they can rarely manifest as autoimmune pancreatitis. Autoimmune pancreatitis is an uncommon disease that may cause recurrent acute pancreatitis and is therefore often regarded as a special type of chronic pancreatitis.
We report a case of a 42-year-old female who had nonspecific upper abdominal pain for 4 years and radiological abnormalities of the pancreas that mimicked autoimmune pancreatitis. The symptoms and pancreatic imaging did not improve following 1 year of steroid therapy. Finally, pancreatic biopsy was performed through endoscopic ultrasonography-guided fine-needle aspiration biopsy, and nonfunctional pancreatic neuroendocrine tumours were ultimately diagnosed. Pancreatectomy has resolved her symptoms.
Therefore, the differentiation of nonfunctional pancreatic neuroendocrine tumours from autoimmune pancreatitis is very important, although it is rare. We propose that endoscopic ultrasonography-guided fine-needle aspiration biopsy should be performed if imaging characteristics are equivocal or the diagnosis is in question.
无功能性胰腺神经内分泌肿瘤因缺乏临床症状，在疾病早期难以诊断，但很少表现为自身免疫性胰腺炎。自身免疫性胰腺炎是一种罕见疾病，可导致复发性急性胰腺炎，因此常被视为一种特殊类型的慢性胰腺炎。
我们报告一例42岁女性，有4年非特异性上腹痛，胰腺影像学异常类似自身免疫性胰腺炎。经过1年的类固醇治疗，症状和胰腺影像学表现均未改善。最后，通过内镜超声引导下细针穿刺活检进行胰腺活检，最终诊断为无功能性胰腺神经内分泌肿瘤。胰腺切除术后症状得到缓解。
因此，尽管无功能性胰腺神经内分泌肿瘤与自身免疫性胰腺炎的鉴别很少见，但非常重要。我们建议，如果影像学特征不明确或诊断存疑，应进行内镜超声引导下细针穿刺活检。
