Yasrab Mohammad, Rizk Ryan C, Lopez-Ramirez Felipe, Ahmed Taha M, Blanco Alejandra, Javed Ammar A, Chu Linda C, Fishman Elliot K, Kawamoto Satomi
Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Surgery, New York University Langone Hospital, New York, NY, USA.
Radiol Case Rep. 2024 Aug 27;19(11):5299-5303. doi: 10.1016/j.radcr.2024.08.018. eCollection 2024 Nov.
Chronic pancreatitis (CP) is a progressive benign fibroinflammatory condition involving repeated episodes of pancreatic inflammation, which lead to fibrotic tissue replacement and subsequent pancreatic insufficiency. A lifetime risk of developing pancreatic ductal adenocarcinoma (PDAC) in patients with chronic pancreatitis is reported to be 1.5%-4%. However, diagnosis of PDAC in patients with CP can be challenging, in part due to overlapping imaging features. In rare instances, pancreatic parenchymal calcifications that are typically associated with chronic pancreatitis may diminish in the case of a developing PDAC. In this article, we present a patient with chronic pancreatitis in whom calcifications decreased at the time of pancreatic ductal adenocarcinoma diagnosis, as compared to prior CT imaging. The unique imaging features of "diminishing calcifications" associated with a hypoattenuating lesion can potentially be a useful sign of pancreatic ductal adenocarcinoma and may aid in early diagnosis and prompt treatment intervention.
慢性胰腺炎（CP）是一种进行性良性纤维炎症性疾病，涉及胰腺炎症反复发作，导致纤维组织替代及随后的胰腺功能不全。据报道，慢性胰腺炎患者一生中发生胰腺导管腺癌（PDAC）的风险为1.5%-4%。然而，CP患者中PDAC的诊断可能具有挑战性，部分原因是影像学特征重叠。在罕见情况下，通常与慢性胰腺炎相关的胰腺实质钙化在发生PDAC时可能会减少。在本文中，我们报告了一名慢性胰腺炎患者，与之前的CT影像相比，其在诊断胰腺导管腺癌时钙化减少。与低密度病变相关的“钙化减少”这一独特影像学特征可能是胰腺导管腺癌的有用征象，有助于早期诊断和及时的治疗干预。
