Reddy Ravikanth
Department of Radiology, St. John's Hospital, Bengaluru, Karnataka, India.
World J Nucl Med. 2022 Aug 25;21(3):239-243. doi: 10.1055/s-0042-1750438. eCollection 2022 Sep.
Mass-forming chronic pancreatitis and pancreatic ductal adenocarcinoma are most commonly located in the head of pancreas, and there is a marked overlap in clinical features and imaging findings that makes it diagnostically challenging, although prognosis and management of both these entities differ. Differentiation is made even more difficult when surgical exploratory biopsy is obtained. Radical surgical resection remains the standard of care for pancreatic ductal adenocarcinoma and conservative treatment is effective for mass-forming chronic pancreatitis. Misdiagnosis of mass-forming chronic pancreatitis as pancreatic ductal adenocarcinoma results in unnecessary surgical intervention, and misdiagnosis of pancreatic ductal adenocarcinoma as mass-forming chronic pancreatitis results in delay in surgical intervention when required. Fluorodeoxyglucose-positron emission tomography/computed tomography can reliably be used for tissue characterization of mass-forming chronic pancreatitis and for monitoring disease response following treatment. Although differentiation of mass-like lesions of pancreas is reliably made on histopathology, significant false-negative rate is a major drawback that has a negative effect on diagnosis. This case report describes a rare presentation of mass-forming chronic pancreatitis with florid dystrophic calcifications in a 60-year-old male.
肿块型慢性胰腺炎和胰腺导管腺癌最常见于胰头，其临床特征和影像学表现存在明显重叠，这使得诊断具有挑战性，尽管这两种疾病的预后和治疗方法有所不同。当进行手术探查活检时，鉴别诊断会更加困难。根治性手术切除仍是胰腺导管腺癌的标准治疗方法，而保守治疗对肿块型慢性胰腺炎有效。将肿块型慢性胰腺炎误诊为胰腺导管腺癌会导致不必要的手术干预，而将胰腺导管腺癌误诊为肿块型慢性胰腺炎则会导致在需要时延迟手术干预。氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描可可靠地用于肿块型慢性胰腺炎的组织特征分析以及治疗后疾病反应的监测。尽管胰腺肿块样病变在组织病理学上能够可靠地鉴别，但显著的假阴性率是一个主要缺点，对诊断有负面影响。本病例报告描述了一名60岁男性罕见的肿块型慢性胰腺炎伴明显营养不良性钙化的表现。
