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Martins C, Lago P, Sousa P, et al. Type 2 Autoimmune Pancreatitis: A Challenge in the Differential Diagnosis of a Pancreatic Mass. GE Port J Gastroenterol. 2017;24(6):296-300doi: 10.1159/000461589.
Martins, C., Lago, P., Sousa, P., Araújo, T., Davide, J., Castro-Poças, F., & Pedroto, I. (2017). Type 2 Autoimmune Pancreatitis: A Challenge in the Differential Diagnosis of a Pancreatic Mass. GE Portuguese journal of gastroenterology, 24(6), 296-300. https://doi.org/10.1159/000461589
Martins, Cláudio, et al. "Type 2 Autoimmune Pancreatitis: A Challenge in the Differential Diagnosis of a Pancreatic Mass." GE Portuguese journal of gastroenterology vol. 24,6 (2017): 296-300. doi: https://doi.org/10.1159/000461589
Martins C, Lago P, Sousa P, Araújo T, Davide J, Castro-Poças F, Pedroto I. Type 2 Autoimmune Pancreatitis: A Challenge in the Differential Diagnosis of a Pancreatic Mass. GE Port J Gastroenterol. 2017 Nov;24(6):296-300. doi: 10.1159/000461589. Epub 2017 Mar 23. PMID: 29255773; PMCID: PMC5731154.
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GE Port J Gastroenterol. 2017 Nov;24(6):296-300. doi: 10.1159/000461589. Epub 2017 Mar 23.

Type 2 Autoimmune Pancreatitis: A Challenge in the Differential Diagnosis of a Pancreatic Mass.

GE Portuguese journal of gastroenterology

Cláudio Martins, Paula Lago, Paula Sousa, Tarcísio Araújo, José Davide, Fernando Castro-Poças, Isabel Pedroto

Affiliations

  1. Department of Gastroenterology, Centro Hospitalar de Setúbal - Hospital de São Bernardo, Setúbal, Portugal.
  2. Department of Gastroenterology, University of Porto, Porto, Portugal.
  3. Department of Gastroenterology, Centro Hospitalar Tondela-Viseu - Hospital de São Teotónio, Viseu, Portugal.
  4. Hepatobiliopancreatic Unit, Centro Hospitalar do Porto - Hospital Geral de Santo António, University of Porto, Porto, Portugal.
  5. Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.

PMID: 29255773 PMCID: PMC5731154 DOI: 10.1159/000461589

Abstract

INTRODUCTION: Autoimmune pancreatitis is a rare entity of unknown etiology that can mimic pancreatic cancer and whose diagnosis involves clinical, serological, imagiological, and histological findings. There are two types of autoimmune pancreatitis: type 1, in which the pancreas is involved as one part of a systemic immunoglobulin G4-related disease, and type 2, generally without immunoglobulin G4-positive cells and without systemic involvement.

CASE: We report the case of a 45-year-old female, who underwent an abdominal magnetic resonance imaging for etiological study of a solid liver lesion, which revealed a tail pancreatic mass. Laboratory analyses showed normal levels of immunoglobulin G4 and negative antinuclear antibodies. Endoscopic ultrasound revealed a homogeneous and hypoechogenic lesion in the pancreatic tail with a "sausage-like" appearance. Endoscopic ultrasound-guided fine needle aspiration was inconclusive and the patient underwent a laparoscopic distal pancreatectomy. Histopathology examination confirmed the diagnosis of type 2 autoimmune pancreatitis.

CONCLUSION: This case highlights the challenge in the diagnostic approach of a pancreatic mass, particularly in distinguishing benign from malignant disease.

Keywords: Autoimmune pancreatitis; Immunoglobulin G4; Pancreatic cancer

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