Autoimmune pancreatitis diagnosed preoperatively with pancreatic ductal cancer: a case report

Name: Work Video:
Duration: 3 min 30 s
Mitsuhiro INAGAKI; Jun-Ichi Goto; Shigeki Suzuki; Tatsuya Abe; Masao KUNIMOTO; Kazumasa NAKAMURA; Yasuhiro Nakano; Satoshi TANNO; Y Kohgo; Yoshihiko TOKUSASHI; Naoyuki MIYOKAWA; Shinichi KASAI
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{'症例は64歳,男性.近医にて指摘された膵体部腫瘍精査目的で来院した.CTでは膵全体がびまん性に腫大し,尾部の造影が不良で体部病変は描出されなかった.血液検査で抗核抗体陽性·IgG4上昇を認めた.EUSでは体部に約15mmの辺縁不整な低エコー腫瘤を描出,体外式造影超音波で同病変部は動脈相から実質相にかけて造影効果の乏しい乏血性腫瘤として描出された.ERPでは膵体部主膵管に長さ23mmの限局性狭細像を認め,同部位の生検で異型細胞を得た.以上の術前血液検査·画像所見は自己免疫性膵炎(AIP)を強く疑わせたが,膵体部癌の合併を否定できず膵体尾部切除術を施行した.病理組織学的検索では,切除膵全体に高度の線維化と,膵実質内にIgG4陽性の炎症性細胞浸潤を認めたが悪性所見はなくAIPと臨床診断した.本例は術前診断で膵癌合併を否定できなかったAIP症例で,今後の鑑別診断において示唆に富むものであった.': [0]}, 'cited_by_api_url': 'https://api.openalex.org/works?filter=cites:W4240204448', 'counts_by_year': [], 'updated_date': '2024-12-16T03:42:15.201197', 'created_date': '2022-05-12'}
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