Mass Forming Chronic Pancreatitis Mimicking a Pancreatic Neoplasm: A Case Report

• Main Author: Sarang Gosavi
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2021-06-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: computed tomography; histopathology; inflammatory changes
• Online Access: https://www.jcdr.net/articles/PDF/14988/48402_CE[Ra1]_F[IK]_PF1(AB_SL)_PFA(AB_KM)_PN(KM).pdf

Chronic pancreatitis can present as a focal inflammatory mass mimicking pancreatic neoplasm and also it has increased risk of developing pancreatic cancer. Even with the help of multiple new imaging modalities, convincing differentiating points between these two entities is not available. Hereby, the author present a case of 50-year-old female with epigastric pain since one month. No significant past history or any history of addictions was present. On clinical examination, there was tenderness in epigastric region, however no lump could be felt. Her laboratory parameters revealed, raised bilirubin levels. Amylase and lipase levels were slightly raised. Computed Tomography (CT) revealed heterogeneously enhancing mass involving head and uncinate process of pancreas with loss of fat planes between lesion and superior mesenteric vessels, atrophic pancreas with dilated pancreatic duct and multiple ductal calculi. CT guided biopsy of pancreatic mass was performed. Histopathology revealed pancreatic tissue with fibrocollagenous and fibroadipose tissue with dense and diffuse infiltration by mononuclear cells, histiocytes and a few foamy macrophages suggestive of acute on chronic inflammation with no evidence of any malignant cells.