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酷似梗阻性胰腺神经内分泌肿瘤的自身免疫性胰腺炎

Autoimmune Pancreatitis Mimicking Obstructive Pancreatic Neuroendocrine Tumor.

作者信息

Haddadin Rakahn, Grewal Amit, Patel Srusty, Merhavy Zachary I, Iraninezhad Homayon

机构信息

Medicine, MountainView Hospital, Las Vegas, USA.

Internal Medicine, MountainView Hospital, Las Vegas, USA.

出版信息

Cureus. 2024 Jul 10;16(7):e64248. doi: 10.7759/cureus.64248. eCollection 2024 Jul.

Abstract

Autoimmune pancreatitis (AIP), otherwise known as non-alcoholic destructive pancreatitis or sclerosing pancreatitis, is a rare form of chronic pancreatitis that is clinically significant due to its potential to mimic pancreatic cancer. In our case, we present a 64-year-old male with a past medical history of type 2 diabetes and epigastric abdominal pain for one year who presented with worsening epigastric abdominal pain, 12-pound weight loss, and vomiting and was found to have a neuroendocrine tumor on a preliminary pathology report, while official pathology later came back stating AIP. Distinguishing between autoimmune pancreatitis (AIP) and pancreatic cancer is vital, given the stark contrast in their treatment and prognosis. In our case, preliminary pathology suggested a neuroendocrine tumor, prompting consultation with oncology. Utilizing invasive testing like EUS-FNA, we obtained an official diagnosis and prevented the patient from undergoing unnecessary treatments and interventions. Our case shows the importance of further testing when a patient presents with a fast-growing obstructive pancreatic mass. While searching the literature, there are no previously documented cases of an AIP mass as large as our patients and as fast-growing.

摘要

自身免疫性胰腺炎(AIP),也被称为非酒精性破坏性胰腺炎或硬化性胰腺炎,是一种罕见的慢性胰腺炎,因其有可能被误诊为胰腺癌而具有临床重要性。在我们的病例中,我们介绍了一名64岁男性,他有2型糖尿病病史,上腹部疼痛一年,此次因上腹部疼痛加重、体重减轻12磅以及呕吐前来就诊,初步病理报告显示患有神经内分泌肿瘤,而最终病理报告结果为自身免疫性胰腺炎。鉴于自身免疫性胰腺炎(AIP)和胰腺癌在治疗和预后方面存在显著差异,区分两者至关重要。在我们的病例中,初步病理提示为神经内分泌肿瘤,因此咨询了肿瘤科。通过使用诸如超声内镜引导下细针穿刺活检(EUS-FNA)等侵入性检查,我们获得了明确诊断,避免了患者接受不必要的治疗和干预。我们的病例表明,当患者出现快速生长的梗阻性胰腺肿块时,进一步检查的重要性。在查阅文献时,此前没有记录过像我们患者这样肿块如此大且生长如此迅速的自身免疫性胰腺炎病例。

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