PMC6514526_01
Contrast-enhanced computed tomography scan showing sausage-like enlargement with homogenous attenuation of the pancreas, a peripheral rim of hypoattenuation "halo," a loss of lobulation (arrows), and a caudally situated cystic lesion (60 x 80 mm; asterisk).
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F1
Computed tomography revealed a diffusely enlarged pancreas ("sausage-like" with loss of lobulation), hypoattenuating, with adjacent edema and a cystic lesion (60 x 80 mm) extending from the pancreatic tail (Fig. 1).
Magnetic resonance imaging on T2-weighted sequences 6 months after initiation of therapy showing a less swollen pancreas with a prominent pancreatic duct (arrows) and a reduction in size of the caudally situated cystic lesion (26 x 11 mm; asterisk).
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F2
Magnetic resonance imaging, performed after 6 months of therapy revealed a partial normalization of the pancreas with a remaining prominent duct, and partial regression of the pancreatic pseudocyst (26 x 11 mm) (Fig. 2).
Graph showing declining IgG4 levels during the therapy.
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F3
Consistently, serum IgG4 concentration also declined to 292 mg/dL after 4 weeks of prednisolone therapy and 159 mg/dL after 16 weeks of therapy (Fig. 3).