Follicular pancreatitis, report of a case clinically mimicking pancreatic cancer and literature review

Yusuke Mizuuchi, Shinichi Aishima, Masami Hattori, Yasuhiro Ushijima, Akira Aso, Shunichi Takahata, Takao Ohtsuka, Junji Ueda, Masao Tanaka, Yoshinao Oda

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Abstract

We herein present a 71-year-old man who underwent pancreatoduodenectomy with the diagnosis of follicular pancreatitis. We could not completely deny malignancy by a preoperative imaging study. Endoscopic ultrasonography-guided fine needle aspiration biopsy demonstrated clusters of benign acinar cells and no proliferation of atypical lymphoid cells or rich plasma cells. Histologically, the prominent lymphoid follicle formation was seen in an ill-defined mass, 15. mm in size, in the pancreatic parenchyma. Duct-centered fibrotic rims were seen in the pancreatic ducts accompanied by mild fibrotic change between the follicles and obliterative phlebitis. No neoplastic epithelial cells were observed in the resected specimen, and infiltrating lymphocytes did not show any morphological atypia and monoclonal proliferation by immunohistochemical staining with B and T cell markers. In addition, we could exclude IgG4-related disease, because plasmacytic cells were rarely positive for IgG4. Although follicular pancreatitis is rare, this mass-forming inflammatory disease (pancreatitis) should be included in the preoperative differential diagnosis of pancreatic cancer.

Original languageEnglish
Pages (from-to)118-122
Number of pages5
JournalPathology Research and Practice
Volume210
Issue number2
DOIs
Publication statusPublished - Feb 1 2014

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All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Cell Biology

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