Multilocular Cyst of Type 1 Autoimmune Pancreatitis Masquerading as Cancerization of Intraductal Papillary Mucinous Neoplasm

Intern Med. 2020 Jan 15;59(2):199-204. doi: 10.2169/internalmedicine.3561-19. Epub 2019 Sep 3.

Abstract

A small proportion of intraductal papillary mucinous neoplasms (IPMNs) are accompanied by type 1 autoimmune pancreatitis (AIP); however their clinical courses and image characteristics have not been fully reported. A 65-year-old woman was referred to our hospital for the examination of a pancreatic head cyst that had shown exacerbation for two years. Several images demonstrated a multilocular cyst with a symmetrically thickened, enhanced, cyst wall. Cancerization of IPMN was suspected, and pancreatoduodenectomy was performed. The resected specimens showed a multilocular cyst with solid areas. The solid areas demonstrated pathological findings that corresponded with type 1 AIP. Papillary epithelia suggestive of IPMN was recognized in some parts of the cystic wall.

Keywords: IgG4; autoimmune pancreatitis; diagnosis; intraductal papillary mucinous neoplasms.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autoimmune Pancreatitis / diagnosis
  • Autoimmune Pancreatitis / pathology*
  • Diagnosis, Differential
  • Disease Progression
  • Female
  • Humans
  • Pancreas / pathology
  • Pancreatic Cyst / diagnosis
  • Pancreatic Cyst / pathology*
  • Pancreatic Intraductal Neoplasms / diagnosis
  • Pancreatic Intraductal Neoplasms / pathology*
  • Pancreatic Intraductal Neoplasms / surgery
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery
  • Pancreaticoduodenectomy