Vujasinovic Miroslav, Ghazi Sam, Kartalis Nikolaos, Gustafsson Liljefors Maria, D'Souza Melroy A, Ghorbani Poya, Löhr J-Matthias
Department of Upper Abdominal Diseases, Karolinska University Hospital, 14186 Stockholm, Sweden.
Department of Medicine Huddinge, Karolinska Institutet, 14186 Stockholm, Sweden.
Biomedicines. 2024 Aug 5;12(8):1762. doi: 10.3390/biomedicines12081762.
Autoimmune pancreatitis (AIP) type 1, paraduodenal (groove) pancreatitis, and follicular pancreatitis are rare clinical entities whose diagnosis may be challenging, given the potential imaging overlap with pancreatic cancer. We performed a retrospective analysis of the medical chart of a patient with multiple pancreas pathologies. We present a case with multiple pancreas pathologies, including a poorly differentiated ductal adenocarcinoma of pancreatobiliary type, an intraductal papillary mucinous lesion (pre-existing lesion of IPMN type), and an inflammatory process with complex features, in which paraduodenal (groove) pancreatitis, follicular pancreatitis, and IgG4-related pancreatitis (AIP type 1) were also present. The diagnosis of AIP and paraduodenal pancreatitis is not always straightforward, and in some cases, it is not easy to differentiate them from pancreatic cancer. Surgery should be considered in patients when a suspicion of malignant/premalignant lesions cannot be excluded after a complete diagnostic work-up.
1型自身免疫性胰腺炎（AIP）、十二指肠旁（沟部）胰腺炎和滤泡性胰腺炎是罕见的临床实体，鉴于其在影像学上可能与胰腺癌重叠，其诊断可能具有挑战性。我们对一名患有多种胰腺病变的患者的病历进行了回顾性分析。我们报告了一例具有多种胰腺病变的病例，包括胰胆管型低分化导管腺癌、导管内乳头状黏液性病变（IPMN型既往病变）以及具有复杂特征的炎症过程，其中还存在十二指肠旁（沟部）胰腺炎、滤泡性胰腺炎和IgG4相关性胰腺炎（1型AIP）。AIP和十二指肠旁胰腺炎的诊断并非总是一目了然，在某些情况下，很难将它们与胰腺癌区分开来。当经过全面的诊断检查后仍不能排除恶性/癌前病变的怀疑时，应考虑对患者进行手术。
