Department of Medicine, Division of Gastroenterology, Jichi Medical University, Japan.
Department of Obstetrics & Gynecology, Jichi Medical University, Japan.
Intern Med. 2024 Mar 15;63(6):791-798. doi: 10.2169/internalmedicine.1943-23. Epub 2023 Aug 2.
A 61-year-old woman was administered 35 cycles of pembrolizumab for the treatment of recurrent endometrial cancer, achieving a complete response. She presented with asymptomatic pancreatic enlargement and elevated hepatobiliary enzymes, but amylase and lipase levels were within the normal ranges. Intrapancreatic bile duct stenosis due to pancreatic enlargement was present, mimicking autoimmune pancreatitis on computed tomography performed before the onset of clinical manifestations. A histological examination of a biopsy specimen showed lymphocyte and plasma cell infiltration with dense fibrosis in the stroma. The patient was successfully treated with oral prednisolone. There were no manifestations of recurrent pancreatitis after tapering the prednisolone dose.
一位 61 岁女性因复发性子宫内膜癌接受了 35 个周期的派姆单抗治疗，达到完全缓解。她表现为无症状性胰腺增大和肝酶升高，但淀粉酶和脂肪酶水平在正常范围内。胰腺增大导致胰内胆管狭窄，在出现临床表现前进行的计算机断层扫描显示类似于自身免疫性胰腺炎。活检标本的组织学检查显示淋巴细胞和浆细胞浸润，基质中有致密纤维化。患者成功接受了口服泼尼松龙治疗。在逐渐减少泼尼松龙剂量后，没有出现胰腺炎复发的表现。
