A pancreatic neuroendocrine tumor with autoimmune pancreatitis and multifocal mass lesions
- 25 December 2019
- journal article
- Published by Japan Pancreas Society in Suizo
- Vol. 34 (6), 302-311
- https://doi.org/10.2958/suizo.34.302
Abstract
症例は71歳女性.腹部US検査で膵頭部に14mmの低エコーの腫瘤像が認められた.超音波内視鏡では膵頭部病変の他,膵尾部に膵頭部と同様なエコー所見を呈する2つの腫瘤(13.4・17.4mm)がみられた.膵頭部・膵尾部病変に対し超音波内視鏡下穿刺吸引細胞診(endoscopic ultrasonography-guided fine needle aspiration:EUS-FNA)を施行したところ,膵尾部病変から膵神経内分泌腫瘍(pancreatic neuroendocrine tumor:pNET)を疑う所見が認められたため,膵頭部腫瘍核出術及び尾側膵切除術,リンパ節郭清術を施行した.手術標本の病理組織検査では膵頭部病変の1つはpNETと診断された.しかし,膵尾部病変は著明なIgG4陽性形質細胞浸潤を伴う線維化の強い炎症性腫瘤で自己免疫性膵炎と診断された.これ以外に,摘出された膵尾部には病理組織検査でのみ確認できる2mm程度の微小なpNETの組織が2箇所認められた.術後経過は良好で,4年間無再発で外来通院中である.This publication has 19 references indexed in Scilit:
- Diagnostic performance and factors influencing the accuracy of EUS-FNA of pancreatic neuroendocrine neoplasmsThe Esophagus, 2016
- ENETS Consensus Guidelines Update for the Management of Patients with Functional Pancreatic Neuroendocrine Tumors and Non-Functional Pancreatic Neuroendocrine TumorsNeuroendocrinology, 2016
- Multifocal lesions with pancreatic atrophy in IgG4-related autoimmune pancreatitis: report of a caseSurgery Today, 2013
- Risk of Cancer in Patients With Autoimmune PancreatitisThe American Journal of Gastroenterology, 2013
- International Consensus Diagnostic Criteria for Autoimmune PancreatitisPancreas, 2011
- Autoimmune Pancreatitis Exhibiting Multiple Mass LesionsCase Reports in Gastroenterology, 2011
- Autoimmune pancreatitis with multifocal lesionsJournal of Hepato-Biliary-Pancreatic Surgery, 2008
- Autoimmune pancreatitis with multifocal mass lesionsRadiation Medicine, 2006
- The roles of endoscopic ultrasonography in the diagnosis of pancreatic tumorsJournal of Hepato-Biliary-Pancreatic Surgery, 2004
- Chronic pancreatitis caused by an autoimmune abnormalityDigestive Diseases and Sciences, 1995