Document Detail


Xanthogranulomatous lesion of the pancreas mimicking pancreatic cancer.
MedLine Citation:
PMID:  18971878     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Xanthogranulomatous lesion is a rare condition that can develop in the gall bladder, kidney, and retroperitoneal space. This lesion is an inflammatory disease. It is commonly accepted that Xanthogranulomatous lesion of the pancreas (XGP) is hardly distinguishable from pancreatic neoplasms. As a result of the similarity of pancreatic cancer in clinical and imaging diagnostic findings, most of all patients have often been performed excessive surgeries. CASE REPORT: An 82-year-old male was admitted to our hospital because of body weight loss. Laboratory tests showed the presence of inflammation, and a Positron emission tomography (PET) revealed positive uptake in the pancreas head and tail, and spleen. Duodeno scopy showed excretion of mucin from the papilla of Vater. Intraductal ultrasonography (IOUS) showed a tumor located at the pancreas tail. Under a preoperative diagnosis of intraductal papillary mucinous carcinoma (IPMC) at the pancreas tail with metastasis to the spleen, distal pancreatectomy and splenectomy were performed. Microscopic findings of the operative specimen revealed massive infiltration of macrophages with fibrosis, the lost of ductal epithelium, and the severe deposition of amyloid and mucin with thrombosis. Pathological diagnosis was XGP. The patient was uneventfully discharged from hospital on the postoperative day 22. Although XGP is a benign condition, most cases are treated by surgery same as our case. This is due to the difficulty in differenciating the lesion from pancreatic cancer. CONCLUSIONS: We reported a rare case of XGP mimicking pancreatic cancer. XGP should be added to one of differential diagnosis of pancreatic cancer.
Authors:
Yukihiro Iso; Nobumi Tagaya; Junji Kita; Tokihiko Sawada; Keiichi Kubota
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Medical science monitor : international medical journal of experimental and clinical research     Volume:  14     ISSN:  1643-3750     ISO Abbreviation:  Med. Sci. Monit.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-30     Completed Date:  2008-12-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609063     Medline TA:  Med Sci Monit     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  CS130-3     Citation Subset:  IM    
Affiliation:
2nd Department of Surgery, Dokkyo Medical University, Tochigi, Japan. karinaiso@yahoo.co.jp
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MeSH Terms
Descriptor/Qualifier:
Aged, 80 and over
Diagnosis, Differential
Duodenoscopy
Humans
Male
Pancreatic Neoplasms / classification*,  diagnosis*,  surgery
Positron-Emission Tomography
Tomography, X-Ray Computed

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