Early pancreatic cancer in IgG4-related pancreatic mass: A case report

Figure 1 Coronal projection of the preoperative abdominal computed tomography scan. A: The pancreatic head tumor can be appreciated; B: Orange arrow showing the plastic stent placed in the bile duct before referral.

Figure 2 Magnetic resonance cholangio-pancreatography showing parietal concentric ingrowth of the main bile duct with stenosis from the hepatic carrefour up to the hepaticojejunostomy with dilatation of intrahepatic bile ducts. A: Axial T2 with concentric parietal growth; B: Diffusion-weighted imaging b800. Hyperintensity; C: Apparent diffusion coefficient with hyperintensity; D: Axial T1 without contrast; E: Axial in a portal phase; F: Three dimensional cholangiography showing dilation of intrahepatic ducts superior to the hepatic carrefour with stenosis from the carrefour up to the anastomosis.

Figure 3 Histopathological analysis of the surgical specimen. A: Limits between normal pancreatic tissue and carcinoma (hematoxylin and eosin 40 ×); B: Lymphoplasmacytic peritumoral infiltration (hematoxylin and eosin 100 ×); C: Plasmacytic peritumoral infiltration (hematoxylin and eosin 400 ×); D: Immunohistochemistry with IgG positive plasma cells; E: Immunohistochemistry with frequent IgG4 positive plasma cells.