PMC7344129_01
The magnetic resonance imaging and magnetic resonance cholangiopancreatography findings of the patient. (a) (T1W MRI) Diffuse enlargement of pancreas and capsule like rim. (b) (T2W MRI) Mild dilatation of intrahepatic bile ducts. (c) (MRCP) Narrowing at the bifurcation of the common hepatic duct. (d) (MRI) Enlarged lacrimal glands with contrast enhancement
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F1
Magnetic resonance imaging (MRI) of the abdomen revealed hepatomegaly with a heterogeneous parenchyma of the liver and a diffuse enlargement of the pancreas, surrounded by a capsule-like rim, and it was compatible with autoimmune pancreatitis (Fig. 1). Further radiologic investigation with magnetic resonance cholangiopancreatography (MRCP) confirmed a narrowing at the bifurcation of the common hepatic duct and mild dilatation of intrahepatic bile ducts (Fig. 1). Orbital MRI demonstrated enlarged lacrimal glands with contrast enhancement (Fig. 1).
Histopathologic findings of liver biopsy (lymphoplasmacytic inflammation around the portal bile ducts with periportal fibrosis and mild bridging necrosis), (H&E, X200)
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F2
The histopathologic examination of liver biopsy showed lymphoplasmacytic inflammation around the portal bile ducts with periportal fibrosis and mild bridging necrosis (Fig. 2).
Radiologic imaging of the pancreas before and after the treatment (resolution of pancreatic enlargement after treatment). (a) Diffuse enlargement of pancreas at diagnosis. (b) Complete resolution of pancreatic enlargement after treatment
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F3
Her signs and symptoms improved dramatically, and follow-up imaging of the abdomen at the second week of treatment demonstrated complete resolution of pancreatic enlargement (Fig. 3).