PMC3304078_01
a Abdominal ultrasonography showed a 15 mm hypoechoic mass located in the pancreatic body without dilatation of the main pancreatic duct (arrow). b Computed tomography revealed a tumor in the pancreatic body without any contrast enhancement (arrow). c Magnetic resonance imaging demonstrated the mass to be hyperintense on diffusion-weighted image (arrow). d Endoscopic retrograde cholangiopancreatography revealed slight dilatation of a branch of the pancreatic duct in the pancreatic body without stricture of the main pancreatic duct and the common bile duct (arrow).
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F1
Abdominal ultrasonography showed a 15-mm hypoechoic mass located in the pancreatic body without dilatation of the main pancreatic duct (fig. 1a). Computed tomography revealed a tumor in the pancreatic body without any contrast enhancement (fig. 1b). Magnetic resonance imaging demonstrated the mass to be hyperintense on diffusion-weighted image (fig. 1c). Endoscopic retrograde cholangiopancreatography revealed slight dilatation of a branch of the pancreatic duct in the pancreatic body without stricture of the main pancreatic duct (fig. 1d).
a Macroscopically, a well-circumscribed solid and elastic firm tumor about 2 cm in diameter with gray-yellow coloration was found. b Histologically, the tumor was not well-circumscribed partially and showed extensive fibrosis and infiltration of lymphocytes, plasma cells, and eosinophils with lymphoid follicles around the pancreatic duct and pancreatic parenchyma, and obliterative venulitis was seen, which are typical features of AIP. H&E staining, x 40. c Immunohistological examination demonstrated that the pancreatic duct was surrounded by abundant IgG4-positive plasma cells. IgG4 staining, x 40.
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F2
Therefore enucleation was performed (fig. 2a). Histologically, the tumor was partially indiscrete and showed extensive fibrosis, and demonstrated infiltration of lymphocytes, plasma cells, and eosinophils with lymphoid follicles around the pancreatic duct and pancreatic parenchyma, and obliterative venulitis, which are typical features of AIP (fig. 2b). Subsequently, immunohistological examination demonstrated that the pancreatic duct was surrounded by abundant IgG4-positive plasma cells (fig. 2c).