Follicular pancreatitis: a distinct form of chronic pancreatitis—an additional mimic of pancreatic neoplasms

Autor: Vikram Deshpande, David S. Klimstra, Rajib K Gupta, Mikhail Lisovsky, Bill H. Xie, Kurt T. Patton, Eric J. Burks, Stephen W. Behrman
Rok vydání: 2016
Předmět:
Zdroj: Human Pathology. 48:154-162
ISSN: 0046-8177
DOI: 10.1016/j.humpath.2015.09.017
Popis: Follicular pancreatitis is a recently described variant of chronic pancreatitis characterized clinically by the formation of a discrete pancreatic mass and histologically by the presence of florid lymphoid aggregates with reactive germinal centers. Our aim was to study the clinical and histologic features of follicular pancreatitis, as well as to critically examine potential overlap with autoimmune pancreatitis. Immunohistochemistry for Bcl-2, CD21, kappa and lambda light chains as well as IgG4 and IgG were performed. We found a total of six patients (male:female = 2:1, mean age = 57 years) who fulfilled the diagnosis of follicular pancreatitis in our institutions. Four had an incidental diagnosis while two presented with abdominal pain, fatigue and elevated liver enzymes. On imaging, three patients had a discrete solid mass while 2 cases showed a dilated main pancreatic duct, mimicking an intraductal pancreatic mucinous neoplasm on imaging. One patient had a lesion in the intra-pancreatic portion of the common bile duct. On histopathology, all cases showed numerous lymphoid follicles with Bcl-2 negative germinal centers either in a periductal or in a more diffuse (periductal and intra-parenchymal) fashion, but without attendant storiform fibrosis, obliterative phlebitis or granulocytic epithelial lesions. IgG4/IgG ratio was
Databáze: OpenAIRE
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