Branch Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas Involving Type 1 Localized Autoimmune Pancreatitis with Normal Serum IgG4 Levels Successfully Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration and Treated without Pancreatic Surgery

Internal Medicine
Shinsuke KoshitaTakashi Sawai

Abstract

We herein report a 68-year-old man with branch duct intraductal papillary mucinous neoplasms of the pancreas (BD-IPMNs) involving type 1 localized autoimmune pancreatitis (AIP) with normal serum IgG4 levels. Although he was referred to our medical center due to suspicion of pancreatic cancer concomitant with BD-IPMNs, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) revealed a mass suspected of being pancreatic cancer to be type 1 AIP. Steroid administration notably reduced the mass. Although the clinical diagnosis of pancreatic masses in patients with IPMN can be occasionally challenging, performing a pathological examination by EUS-FNA may prevent unnecessary pancreatic surgery in cases of possible AIP.

References

Mar 18, 2011·Pancreas·Tooru ShimosegawaUNKNOWN International Association of Pancreatology
Jul 12, 2011·Gastrointestinal Endoscopy·Shinsuke KoshitaTakahisa Ogawa
Jan 16, 2013·The American Journal of Gastroenterology·Masahiro ShiokawaTsutomu Chiba
Jul 31, 2013·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Taku TabataGunter Kloppel
Jan 1, 2014·World Journal of Gastroenterology : WJG·Takahiro UrataMichio Hifumi

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