A case of pancreatic ductal adenocarcinoma concomitant with IgG4-related disease in the pancreas and the stomach

被引：1

作者：

Gonda, Masanori ^{[1
]}

Kobayashi, Takashi ^{[1
]}

Notohara, Kenji ^{[2
]}

Abe, Shohei ^{[1
]}

Yamakawa, Kohei ^{[1
]}

Sakai, Arata ^{[1
]}

Masuda, Atsuhiro ^{[1
]}

Toyama, Hirochika ^{[3
]}

Fukumoto, Takumi ^{[3
]}

Kodama, Yuzo ^{[1
]}

机构：

[1] Kobe Univ, Dept Internal Med, Div Gastroenterol, Grad Sch Med, 7 5 1 Kusunoki cho,Chuo ku, Kobe, Hyogo 6500017, Japan

[2] Kurashiki Cent Hosp, Dept Anat Pathol, Kurashiki, Okayama 7108602, Japan

[3] Kobe Univ, Dept Surg, Div Hepatobiliary Pancreat Surg, Grad Sch Med, 7 5 1 Kusunoki cho,Chuo ku, Kobe, Hyogo 6500017, Japan

来源：

CLINICAL JOURNAL OF GASTROENTEROLOGY | 2023年 / 16卷 / 05期

关键词：

IgG4-related diseases; Pancreatic ductal adenocarcinoma; Autoimmune pancreatitis; AUTOIMMUNE PANCREATITIS; CANCER; RISK;

D O I：

10.1007/s12328-023-01814-w

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

A 75-year-old Japanese woman visited a hospital with a stomachache. The patient was diagnosed with localized mild acute pancreatitis. Blood tests revealed elevated serum IgG4 levels. Contrast-enhanced computed tomography showed a hypovascular mass, 3 cm in size, in the pancreatic body with dilation of the upstream duct. Additionally, it showed another tumorous lesion of 10 mm in size in the anterior wall of the stomach, and endoscopic examination confirmed a submucosal tumor (SMT) sized 10 mm in the anterior wall of the stomach. Endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB) of the pancreas revealed an adenocarcinoma concomitant with marked IgG4-positive cell infiltration. Hence, distal pancreatectomy with local gastrectomy was performed, and the final diagnosis was concluded as pancreatic ductal adenocarcinoma (PDAC) complicated by IgG4-related diseases (IgG4-RD) in the pancreas and stomach. IgG4-RD of the digestive tract is exceedingly rare. The correlation between PDAC and autoimmune pancreatitis or malignancy and IgG4-RD is controversial. However, the clinical course and histopathological examination, in this case, provide valuable suggestive findings for further discussion.

引用

页码：785 / 790

页数：6

共 16 条

[1] IgG4-Related Diseases in the Gastrointestinal Tract: Clinical Presentation, Diagnosis and Treatment Challenges [J].

Backhus, Johanna ;

Seufferlein, Thomas ;

Perkhofer, Lukas ;

Hermann, Patrick C. ;

Kleger, Alexander .

DIGESTION, 2019, 100 (01) :1-14

[2] Inflammation: the incubator of the tumor microenvironment [J].

Denk, Dominic ;

Greten, Florian R. .

TRENDS IN CANCER, 2022, 8 (11) :901-914

[3] Does Autoimmune Pancreatitis Increase the Risk of Pancreatic Carcinoma? A Retrospective Analysis of Pancreatic Resections [J].

Gupta, Rajib ;

Khosroshahi, Arezou ;

Shinagare, Shweta ;

Fernandez, Carlos ;

Ferrone, Cristina ;

Lauwers, Gregory Y. ;

Stone, John H. ;

Deshpande, Vikram .

PANCREAS, 2013, 42 (03) :506-510

[4] Incidence of Malignancies in Patients with IgG4-related Disease [J].

Hirano, Kenji ;

Tada, Minoru ;

Sasahira, Naoki ;

Isayama, Hiroyuki ;

Mizuno, Suguru ;

Takagi, Kaoru ;

Watanabe, Takeo ;

Saito, Tomotaka ;

Kawahata, Shuhei ;

Uchino, Rie ;

Hamada, Tsuyoshi ;

Miyabayashi, Koji ;

Mohri, Dai ;

Sasaki, Takashi ;

Kogure, Hirofumi ;

Yamamoto, Natsuyo ;

Nakai, Yousuke ;

Yoshida, Haruhiko ;

Ito, Yukiko ;

Akiyama, Dai ;

Toda, Nobuo ;

Arizumi, Toshihiko ;

Yagioka, Hiroshi ;

Takahara, Naminatsu ;

Matsubara, Saburo ;

Yashima, Yoko ;

Koike, Kazuhiko .

INTERNAL MEDICINE, 2014, 53 (03) :171-176

[5] Relationship between autoimmune pancreatitis and pancreatic cancer: A single-center experience [J].

Ikeura, Tsukasa ;

Miyoshi, Hideaki ;

Uchida, Kazushige ;

Fukui, Toshiro ;

Shimatani, Masaaki ;

Fukui, Yuri ;

Sumimoto, Kimi ;

Matsushita, Mitsunobu ;

Takaoka, Makoto ;

Okazaki, Kazuichi .

PANCREATOLOGY, 2014, 14 (05) :373-379

[6] IgG4-related disease [J].

Kamisawa, Terumi ;

Zen, Yoh ;

Pillai, Shiv ;

Stone, John H. .

LANCET, 2015, 385 (9976) :1460-1471

[7] Chronic Pancreatitis and Pancreatic Cancer [J].

Kong, Xiangyu ;

Sun, Tao ;

Kong, Fanyang ;

Du, Yiqi ;

Li, Zhaoshen .

GASTROINTESTINAL TUMORS, 2014, 1 (03) :123-134

[8] IgG4-related diseases of the digestive tract [J].

Lohr, J-Matthias ;

Vujasinovic, Miroslav ;

Rosendahl, Jonas ;

Stone, John H. ;

Beuers, Ulrich .

NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY, 2022, 19 (03) :185-197

[9] Gastrointestinal manifestation of immunoglobulin G4-related disease: clarification through a multicenter survey [J].

Notohara, Kenji ;

Kamisawa, Terumi ;

Uchida, Kazushige ;

Zen, Yoh ;

Kawano, Mitsuhiro ;

Kasashima, Satomi ;

Sato, Yasuharu ;

Shiokawa, Masahiro ;

Uehara, Takeshi ;

Yoshifuji, Hajime ;

Hayashi, Hiroko ;

Inoue, Koichi ;

Iwasaki, Keisuke ;

Kawano, Hiroo ;

Matsubayashi, Hiroyuki ;

Moritani, Yukitoshi ;

Murakawa, Katsuhiko ;

Oka, Yoshio ;

Tateno, Masatoshi ;

Okazaki, Kazuichi ;

Chiba, Tsutomu .

JOURNAL OF GASTROENTEROLOGY, 2018, 53 (07) :845-853

[10] Laminin 511 is a target antigen in autoimmune pancreatitis [J].

Shiokawa, Masahiro ;

Kodama, Yuzo ;

Sekiguchi, Kiyotoshi ;

Kuwada, Takeshi ;

Tomono, Teruko ;

Kuriyama, Katsutoshi ;

Yamazaki, Hajime ;

Morita, Toshihiro ;

Marui, Saiko ;

Sogabe, Yuko ;

Kakiuchi, Nobuyuki ;

Matsumori, Tomoaki ;

Mima, Atsushi ;

Nishikawa, Yoshihiro ;

Ueda, Tatsuki ;

Tsuda, Motoyuki ;

Yamauchi, Yuki ;

Sakuma, Yojiro ;

Maruno, Takahisa ;

Uza, Norimitsu ;

Tsuruyama, Tatsuaki ;

Mimori, Tsuneyo ;

Seno, Hiroshi ;

Chiba, Tsutomu .

SCIENCE TRANSLATIONAL MEDICINE, 2018, 10 (453)

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