Focal IgG4-related autoimmune pancreatitis with distal choledochal adenocarcinoma: a rare case report

Abstract Background Autoimmune pancreatitis (AIP) is a rare disease that manifests as pancreatic involvement in systemic IgG4-related disease (IgG4-RD), a special type of chronic pancreatitis caused by autoimmune abnormalities. The main imaging manifestations of IgG4-related AIP consist of diffuse o...

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Autores principales:	Han Wang, Lan Yao, Ligang Wang, Xixi Sun, Bin Huang
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	IgG4 Autoimmune pancreatitis Carcinoma of bile duct IgG4-related disease Case report Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/e3a6fab6101240e589a418f2c2acfed6
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spelling	oai:doaj.org-article:e3a6fab6101240e589a418f2c2acfed62021-11-14T12:16:47ZFocal IgG4-related autoimmune pancreatitis with distal choledochal adenocarcinoma: a rare case report10.1186/s12876-021-01996-y1471-230Xhttps://doaj.org/article/e3a6fab6101240e589a418f2c2acfed62021-11-01T00:00:00Zhttps://doi.org/10.1186/s12876-021-01996-yhttps://doaj.org/toc/1471-230XAbstract Background Autoimmune pancreatitis (AIP) is a rare disease that manifests as pancreatic involvement in systemic IgG4-related disease (IgG4-RD), a special type of chronic pancreatitis caused by autoimmune abnormalities. The main imaging manifestations of IgG4-related AIP consist of diffuse or localized pancreatic enlargement and irregular pancreatic duct narrowing. The diagnosis of AIP is challenging because it can present with focal lesions, similar to radiologically bile duct cancer or pancreatic cancer. Case presentation A 55-year-old male patient was admitted with painless jaundice and multiple radiographic findings of pancreatic head mass, as well as intrahepatic and extrahepatic bile duct dilatation. Various imaging methods indicated pancreatic cancer. However, the endoscopic ultrasonography guided fine needle aspiration (EUS-FNA) and a laparoscopic pancreatic biopsy suggested an IgG4-related AIP. After one month, magnetic resonance imaging showed that the lesion had slightly grown. Combined with CA19-9 and other indexes, the possibility of malignancy was high and there were still surgical indications. The pathological analysis following a pancreaticoduodenectomy revealed poorly differentiated adenocarcinoma in the distal common bile duct. Conclusion To date, few reports have described pancreatic or extrapancreatic malignancies in AIP patients, and no association between AIP and bile duct adenocarcinoma has been previously confirmed. This case discuss the differentiation between AIP and malignancy, recent research progress, and the correlation between the two diseases, highlights the importance of carefully evaluating patients with AIP to rule out potential tumors, as well as the critical need for follow up treatment.Han WangLan YaoLigang WangXixi SunBin HuangBMCarticleIgG4Autoimmune pancreatitisCarcinoma of bile ductIgG4-related diseaseCase reportDiseases of the digestive system. GastroenterologyRC799-869ENBMC Gastroenterology, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	IgG4 Autoimmune pancreatitis Carcinoma of bile duct IgG4-related disease Case report Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	IgG4 Autoimmune pancreatitis Carcinoma of bile duct IgG4-related disease Case report Diseases of the digestive system. Gastroenterology RC799-869 Han Wang Lan Yao Ligang Wang Xixi Sun Bin Huang Focal IgG4-related autoimmune pancreatitis with distal choledochal adenocarcinoma: a rare case report
description	Abstract Background Autoimmune pancreatitis (AIP) is a rare disease that manifests as pancreatic involvement in systemic IgG4-related disease (IgG4-RD), a special type of chronic pancreatitis caused by autoimmune abnormalities. The main imaging manifestations of IgG4-related AIP consist of diffuse or localized pancreatic enlargement and irregular pancreatic duct narrowing. The diagnosis of AIP is challenging because it can present with focal lesions, similar to radiologically bile duct cancer or pancreatic cancer. Case presentation A 55-year-old male patient was admitted with painless jaundice and multiple radiographic findings of pancreatic head mass, as well as intrahepatic and extrahepatic bile duct dilatation. Various imaging methods indicated pancreatic cancer. However, the endoscopic ultrasonography guided fine needle aspiration (EUS-FNA) and a laparoscopic pancreatic biopsy suggested an IgG4-related AIP. After one month, magnetic resonance imaging showed that the lesion had slightly grown. Combined with CA19-9 and other indexes, the possibility of malignancy was high and there were still surgical indications. The pathological analysis following a pancreaticoduodenectomy revealed poorly differentiated adenocarcinoma in the distal common bile duct. Conclusion To date, few reports have described pancreatic or extrapancreatic malignancies in AIP patients, and no association between AIP and bile duct adenocarcinoma has been previously confirmed. This case discuss the differentiation between AIP and malignancy, recent research progress, and the correlation between the two diseases, highlights the importance of carefully evaluating patients with AIP to rule out potential tumors, as well as the critical need for follow up treatment.
format	article
author	Han Wang Lan Yao Ligang Wang Xixi Sun Bin Huang
author_facet	Han Wang Lan Yao Ligang Wang Xixi Sun Bin Huang
author_sort	Han Wang
title	Focal IgG4-related autoimmune pancreatitis with distal choledochal adenocarcinoma: a rare case report
title_short	Focal IgG4-related autoimmune pancreatitis with distal choledochal adenocarcinoma: a rare case report
title_full	Focal IgG4-related autoimmune pancreatitis with distal choledochal adenocarcinoma: a rare case report
title_fullStr	Focal IgG4-related autoimmune pancreatitis with distal choledochal adenocarcinoma: a rare case report
title_full_unstemmed	Focal IgG4-related autoimmune pancreatitis with distal choledochal adenocarcinoma: a rare case report
title_sort	focal igg4-related autoimmune pancreatitis with distal choledochal adenocarcinoma: a rare case report
publisher	BMC
publishDate	2021
url	https://doaj.org/article/e3a6fab6101240e589a418f2c2acfed6
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Focal IgG4-related autoimmune pancreatitis with distal choledochal adenocarcinoma: a rare case report

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