PMC3932382_01
(A) Abdominal computed tomography scan showing a massive, multifocal air filled abscess originating from the pancreas expanding into the retropancreatic space with invasion of adjacent structures such as the small intestine and posterior aspect of the stomach. (B) Pathological appearance of the pancreas at the first admission. The pathology of the first operative specimen revealed chronic inflammatory cells around the pancreatic duct with interlobular and perilobular fibrosis (H&E, x 100).
kjim-29-116-g001.jpg
PMC3932382_01_kjim-29-116-g001.jpg
F1
An abdominal computed tomography (CT) scan revealed a massive retroperitoneal abscess originating from the pancreas (Fig. 1A). The postoperative pathological diagnosis was chronic pancreatitis with fibrosis (Fig. 1B).
(A) Abdominal computer tomography scan of the reoperative specimen. Although the air filled abscess lesion was drained, the mass continued to grow and expand into the adjunct structures. (B) Low power microscopic view of the reoperative specimen showing tumor cells of variable size with a tubular, papillary pattern (H&E, x 40). (C) High power microscopic view showing tumor cells with a tubular growth pattern and focal infiltration (H&E, x 200). The tumor cells had a columnar shape with a moderate amount of eosinophilic cytoplasm and hyperchromatic nuclei.
kjim-29-116-g002.jpg
PMC3932382_01_kjim-29-116-g002.jpg
F2
At follow-up, the abdominal CT scan revealed that the abscess had increased in size (Fig. 2A), and her general condition had not improved. We reoperated on the pancreatic mass and confirmed the diagnosis of pancreatic adenocarcinoma complicated by a pancreas abscess (Fig. 2B and 2C).