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首页> 外文期刊>Journal of Medical Case Reports >An unusual case of autoimmune pancreatitis presenting as pancreatic mass and obstructive jaundice: a case report and review of the literature
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An unusual case of autoimmune pancreatitis presenting as pancreatic mass and obstructive jaundice: a case report and review of the literature

机译：自身免疫性胰腺炎的罕见病例，表现为胰腺肿块和阻塞性黄疸：一例病例报告并文献复习

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Background Autoimmune pancreatitis is a rare chronic inflammatory pancreatic disease that is increasingly being diagnosed worldwide. As a result of overlap in clinical and radiological features, it is often misdiagnosed as pancreatic cancer. We report the case of a patient with autoimmune pancreatitis that was initially misdiagnosed as pancreatic cancer. Case presentation A 31-year-old Caucasian man presented to our hospital with epigastric pain, jaundice and weight loss. His CA 19-9 level was elevated, and computed tomography and endoscopic ultrasound revealed a pancreatic head mass abutting the portal vein. Endoscopic retrograde cholangiopancreaticography showed narrowing of the biliary duct and poor visualization of the pancreatic duct. Fine-needle aspiration biopsy revealed atypical ductal epithelial cells, which raised clinical suspicion of adenocarcinoma. Because of the patient's unusual age for the onset of pancreatic cancer and the acuity of his symptoms, he was referred to a tertiary care center for further evaluation. His immunoglobulin G4 antibody level was 365 mg/dL, and repeat computed tomography showed features typical of autoimmune pancreatitis. The patient's symptoms resolved with corticosteroid therapy. Conclusion Autoimmune pancreatitis is a rare disease with an excellent response to corticosteroid therapy. Its unique histological appearance and response to corticosteroid therapy can reduce unnecessary surgical procedures. A thorough evaluation by a multidisciplinary team is important in rendering the diagnosis of autoimmune pancreatitis.
机译：背景技术自身免疫性胰腺炎是一种罕见的慢性炎症性胰腺疾病，在世界范围内被越来越多地诊断。由于临床和放射学特征的重叠，经常将其误诊为胰腺癌。我们报告了最初被误诊为胰腺癌的自身免疫性胰腺炎患者的病例。病例介绍一名31岁的白人男子因胃epi痛，黄疸和体重减轻到我院就诊。他的CA 19-9水平升高，计算机断层扫描和内镜超声检查发现胰头肿块紧靠门静脉。内镜逆行胰胆管造影显示胆管狭窄，胰管可视性差。细针穿刺活检显示不典型的导管上皮细胞，这引起了对腺癌的临床怀疑。由于患者因胰腺癌的发病年龄不同寻常且症状敏锐，他被转诊至三级医疗中心进行进一步评估。他的免疫球蛋白G4抗体水平为365 mg / dL，重复进行的计算机体层摄影术显示出自身免疫性胰腺炎的典型特征。皮质类固醇激素疗法可缓解患者的症状。结论自身免疫性胰腺炎是一种罕见病，对皮质类固醇激素治疗反应良好。其独特的组织学外观和对皮质类固醇疗法的反应可减少不必要的手术程序。多学科团队的全面评估对于诊断自身免疫性胰腺炎很重要。

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