Yokoi Y, Nakamura I, Kaneko T, Sawayanagi T, Watahiki Y, Kuroda M. Pancreatic mass as an initial manifestation of polyarteritis nodosa: A case report and review of the literature. World J Gastroenterol 2015; 21(3): 1014-1019 [PMID: 25624739 DOI: 10.3748/wjg.v21.i3.1014]
Corresponding Author of This Article
Yoshihiro Yokoi, MD, Department of Surgery, Shinshiro Municipal Hospital, 32-1 Kitahata, Shinshiro, Aichi 441-1387, Japan. y.yokoi@hospital.shinshiro.aichi.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yoshihiro Yokoi, Takeshi Kaneko, Tomoki Sawayanagi, Youichi Watahiki, Department of Surgery, Shinshiro Municipal Hospital, Aichi 441-1387, Japan
Ippei Nakamura, Department of Internal Medicine, Shinshiro Municipal Hospital, Aichi 441-1387, Japan
Makoto Kuroda, Department of Pathology, Fujita Health University, Aichi 470-1192, Japan
Author contributions: Yokoi Y, Nakamura I, Kaneko T, Sawayanagi T and Watahiki Y participated in the diagnosis, management and follow-up of this clinical case; Kuroda M provided a critical and valuable discussion on the histopathological study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yoshihiro Yokoi, MD, Department of Surgery, Shinshiro Municipal Hospital, 32-1 Kitahata, Shinshiro, Aichi 441-1387, Japan. y.yokoi@hospital.shinshiro.aichi.jp
Telephone: +81-536-222171 Fax: +81-536-222850
Received: June 3, 2014 Peer-review started: June 4, 2014 First decision: July 9, 2014 Revised: July 29, 2014 Accepted: September 18, 2014 Article in press: September 19, 2014 Published online: January 21, 2015
Core Tip
Core tip: A 66-year-old woman presented with a pancreatic mass accompanied by fever, cholestasis and positive myeloperoxidase anti-neutrophil cytoplasmic antibodies. The resected pancreas showed extensive fibrosis associated with necrotizing vasculitis, targeting medium-sized vessels but sparing small-caliber vessels, a finding compatible with polyarteritis nodosa. Unexpectedly, renal biopsy revealed small-caliber vasculitis and glomerulonephritis, supporting microscopic polyangiitis. The initial manifestation of a pancreatic mass associated with vasculitis has only been reported in 7 articles. Although rare, vasculitis should be included in a differential diagnosis for pancreatic masses. Additionally, our findings may reflect a polyangiitis overlap syndrome coexisting between pancreatic polyarteritis nodosa and renal microscopic polyangiitis.
