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World J Gastroenterol. Jun 21, 2010; 16(23): 2954-2958
Published online Jun 21, 2010. doi: 10.3748/wjg.v16.i23.2954
Published online Jun 21, 2010. doi: 10.3748/wjg.v16.i23.2954
Autoimmune pancreatitis with atypical imaging findings that mimicked an endocrine tumor
Cindy Neuzillet, Céline Lepère, Hajer Turki, Philippe Rougier, Emmanuel Mitry, Department of Digestive Surgery and Gastroenterology and Digestive Oncology, Ambroise Paré Hospital, 9, avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
Mostafa El Hajjam, Radiology Unit, Ambroise Paré Hospital, 9, avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France
Laurent Palazzo, Medical office of Gastroenterology, 30, rue d’Astorg, 75008 Paris, France
Monique Fabre, Pathology Unit, Bicêtre Hospital, 78, rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
Pascal Hammel, Department of Digestive Surgery and Gastroenterology, PMAD, Beaujon Hospital, 100 boulevard du Général Leclerc, 92110 Clichy, France
Philippe Rougier, Emmanuel Mitry, EA 4340, Faculty of Medicine of West Paris University of Versailles Saint-Quentin, 9 boulevard d'Alembert, 78280 Guyancourt, France
Author contributions: Neuzillet C collected and analyzed data; El Hajjam M performed radiological examinations; Palazzo L performed endoscopic explorations; Fabre M performed pathological examinations; Lepère C, El Hajjam M, Fabre M, Turki H, Hammel P and Rougier P contributed reagents; Neuzillet C and Mitry E wrote the paper.
Correspondence to: Emmanuel Mitry, Professor, Department of Gastroenterology and Digestive Oncology, Ambroise Paré Hospital, 9, avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France. emmanuel.mitry@apr.aphp.fr
Telephone: +33-1-49095874 Fax: +33-1-49094508
Received: February 19, 2010
Revised: March 25, 2010
Accepted: April 1, 2010
Published online: June 21, 2010
Revised: March 25, 2010
Accepted: April 1, 2010
Published online: June 21, 2010
Abstract
Autoimmune pancreatitis (AIP) is a rare cause of recurrent acute pancreatitis or chronic pancreatitis in middle-aged patients, and is characterised by a marked infiltration of lymphocytes and plasma cells in pancreatic tissue. Diagnosis of focal forms can be difficult as AIP may mimic pancreatic adenocarcinoma. Pediatric cases of AIP are exceptional. We report the case of a 15-year-old girl who had a focal AIP and associated cholangitis, with a very unusual vascularized mass that mimicked a pancreatic endocrine tumor. The diagnosis was obtained by a pancreatic biopsy, thus avoiding surgical resection, and all the clinical, biological and radiological abnormalities resolved after steroid therapy with 6 mo of follow-up.
Keywords: Pancreas, Autoimmune pancreatitis, Adolescent, Endocrine tumor, Biopsy