A Case of Pancreatic Body Cancer Associated with Autoimmune Pancreatitis with Localized Narrowing of the Main Pancreatic Duct

Hiroyasu Nishizawa, Koji Fujimoto, Kazuhiko Yamagami, Takatomo Koshiba, Naoki Koizumi, Masayuki Yamamoto, Kiyoshi Mori¹⁾, Takeshi Kondo¹⁾, Shinichi Ban²⁾ and Michio Shimizu²⁾

Department of Surgery, Shinko Hospital
Division of Pathology, Kobe University¹⁾
Department of Pathology, Saitama Medical University International Medical Center²⁾

We report a case of pancreatic body cancer associated with autoimmune pancreatitis (AIP) with localized narrowing of the main pancreatic duct. A 61-year-old man admitted to evaluate a pancreatic body tumor was found in abdominal CT and endoscopic US to have an enlarged pancreatic body and a pancreatic body tumor with multiple cysts. ERCP and MRCP showed severe localized narrowing of the main pancreatic duct in the pancreatic body. Serum IgG4 and Dupan-2 were high. Based on these results and a diagnosis of AIP with high suspicion of pancreatic body cancer, we conducted distal pancreatectomy. Pathological examination showed well-differentiated tubular adenocarcinoma within the tumor, together with fibroinflammatory lesions with infiltration of IgG4-positive plasma cells surrounding the tumor and compatible with AIP. In addition to AIP cases with localized narrowing of the main pancreatic duct reported, our case suggests AIP might coexist with pancreatic cancer.

Key words
autoimmune pancreatitis, IgG4, pancreatic cancer

Reprint requests
Hiroyasu Nishizawa Department of Surgery, Shinko Hospital
1-4-47 Wakinohama-cho, Chuo-ku, Kobe, 651-0072 JAPAN

Accepted
November 19, 2008

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