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伴有沟部胰腺炎患者的胰腺癌:诊断中的潜在陷阱

Pancreatic cancer in patient with groove pancreatitis: Potential pitfalls in diagnosis.

作者信息

Lugo-Fagundo Elias, Weisberg Edmund M, Fishman Elliot K

机构信息

Johns Hopkins Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, 601 North Caroline Street, Baltimore, MD 21287, USA.

出版信息

Radiol Case Rep. 2022 Sep 29;17(12):4632-4635. doi: 10.1016/j.radcr.2022.09.020. eCollection 2022 Dec.

Abstract

Pancreatic cancer is among the leading causes of cancer death in the United States of America. Early detection and intervention are critical as a large majority of patients have either local or distant metastatic disease at the time of diagnosis. However, groove pancreatitis, a rare form of chronic pancreatitis, presents as a challenge for adequate and efficient differential diagnosis of pancreatic cancer as a result of similar clinical symptoms and imaging features. Furthermore, intraductal papillary mucinous neoplasms and pancreatic intraepithelial neoplasia are 2 of the precursor lesions that have been identified with pancreatic ductal adenocarcinoma. Intraductal papillary mucinous neoplasms are cystic tumors of the pancreas characterized by excessive mucin production in either the main pancreatic duct or its branches. Conversely, pancreatic intraepithelial neoplasia are microscopic lesions in the smaller pancreatic ducts. In this article, we report the case of a 46-year-old male with a diagnosis of groove pancreatitis, main duct intraductal papillary mucinous neoplasm, and pancreatic intraepithelial neoplasia whose tumor was excised by means of a Whipple procedure. We focus on optimizing diagnosis and treatment through the application of radiological modalities.

摘要

在美国,胰腺癌是癌症死亡的主要原因之一。由于大多数患者在诊断时已患有局部或远处转移性疾病,早期检测和干预至关重要。然而,沟部胰腺炎作为一种罕见的慢性胰腺炎形式,因其临床症状和影像学特征相似,对胰腺癌进行充分且有效的鉴别诊断构成了挑战。此外,导管内乳头状黏液性肿瘤和胰腺上皮内瘤变是已被确定与胰腺导管腺癌相关的两种前驱病变。导管内乳头状黏液性肿瘤是胰腺的囊性肿瘤,其特征是在主胰管或其分支中产生过多黏液。相反,胰腺上皮内瘤变是较小胰管中的微观病变。在本文中,我们报告了一例46岁男性患者的病例,该患者被诊断为沟部胰腺炎、主胰管导管内乳头状黏液性肿瘤和胰腺上皮内瘤变,其肿瘤通过惠普尔手术切除。我们专注于通过应用放射学检查方法优化诊断和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06de/9530484/11b887454cc1/gr1.jpg

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