Synchronous autoimmune pancreatitis and infiltrating pancreatic ductal adenocarcinoma: case report and review of the literature

Agnieszka K. Witkiewicz, Eugene P. Kennedy, Lawrence Kennyon, Charles J. Yeo, Ralph H. Hruban

Research output: Contribution to journalArticle

Abstract

An 80-year-old white man underwent pylorus-preserving pancreaticoduodenectomy after presenting with obstructive jaundice and a dilated biliary tree on cholangiopancreatography. Histologic evaluation of the specimen revealed synchronous autoimmune pancreatitis (lymphoplasmacytic sclerosing pancreatitis) and infiltrating ductal adenocarcinoma of the pancreas. The mixed inflammatory infiltrate centered on the pancreatic ducts was associated with acinar loss, parenchymal fibrosis, and obliterative venulitis. Immunohistochemical labeling with an antibody to IgG4 revealed greater than 50 IgG4-positive plasma cells per high power field. Although not appreciated grossly, pancreatic intraepithelial neoplasia-3 and a neurotropic infiltrating poorly differentiated adenocarcinoma of the pancreas were also present. This case highlights the importance of carefully evaluating patients with autoimmune pancreatitis to rule out an underlying neoplasm and the importance of following those who were treated nonsurgically until the disease fully resolves. Crown

Original languageEnglish (US)
Pages (from-to)1548-1551
Number of pages4
JournalHuman pathology
Volume39
Issue number10
DOIs
StatePublished - Oct 1 2008

Keywords

  • Autoimmune pancreatitis
  • Lymphoplasmacytic sclerosing pancreatitis
  • Pancreatic adenocarcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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