胰腺导管腺癌合并自身免疫性胰腺炎：一例报告及文献综述

Sakurai Yusuke, Yokoyama Kensuke, Kanno Atsushi, Tanaka Akitsugu, Ikeda Eriko, Ando Kozue, Taguchi Masanobu, Sasanuma Hideki, Sata Naohiro, Sano Naoki, Fukushima Noriyoshi, Yamamoto Hironori

Department of Medicine, Division of Gastroenterology, Jichi Medical University, Japan.

Department of Pathology, Jichi Medical University, Japan.

Intern Med. 2025 May 15;64(10):1525-1533. doi: 10.2169/internalmedicine.4361-24. Epub 2024 Oct 25.

A 50-year-old man was diagnosed with type 1 autoimmune pancreatitis (AIP) following endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and a histopathological examination. After six months of untreated follow-up, the serum IgG4 level decreased, and the diffuse pancreatic enlargement improved; however, a pancreatic head mass became apparent. EUS-FNA of this mass revealed pancreatic ductal adenocarcinoma (PDAC) with IgG4-positive plasma cells. In addition, the resected specimen revealed PDAC, without any features of AIP. After pancreatoduodenectomy, AIP did not recur. The development of AIP in this case could be related to paraneoplastic syndrome.

一名50岁男性经内镜超声引导下细针穿刺活检（EUS-FNA）及组织病理学检查后被诊断为1型自身免疫性胰腺炎（AIP）。未经治疗随访6个月后，血清IgG4水平下降，胰腺弥漫性肿大有所改善；然而，胰头肿块变得明显。对该肿块进行EUS-FNA检查发现为伴有IgG4阳性浆细胞的胰腺导管腺癌（PDAC）。此外，切除标本显示为PDAC，无任何AIP特征。胰十二指肠切除术后，AIP未复发。该病例中AIP的发生可能与副肿瘤综合征有关。