PMC4357679_01
CT scan showing the typical enlarged (1.97 cm) 'sausage-shaped' pancreas and a double duct sign. DHC = Common bile duct; PD = pancreatic duct.
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F1
A CT scan showed a double duct sign without clear delineated tumor, no calcification of the pancreas nor infiltration of the vessels (fig. 1).
Photomicrograph of elastica van Gieson staining showing chronic inflammation of the pancreas with sclerosis and parenchymal atrophy. Magnification x400.
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F2
This one showed chronic periductal inflammation with infiltration of plasma cells, sclerosis, venulitis, parenchymal atrophy (fig. 2, fig. 3a) and strong positive immunohistochemical staining for IgG4 (fig. 3a, b).
Immunohistochemical staining for IgG4 showing numerous IgG4-positive plasma cells surrounding pancreatic hyperplastic ducts (a; magnification x200) and single positive cells in chronic inflammation (b; magnification x400).
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F3
This one showed chronic periductal inflammation with infiltration of plasma cells, sclerosis, venulitis, parenchymal atrophy (fig. 2, fig. 3a) and strong positive immunohistochemical staining for IgG4 (fig. 3a, b).
CT scan showing a less prominent pancreas (1.68 cm) and resolution of bile duct dilation.
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F4
Nevertheless, neither calcification nor tumor mass was found (fig. 4).