Localized 18F-fluorodeoxyglucose uptake at the pancreatic head during remission phase of autoimmune pancreatitis: A case report

Yonenaga,Yoshikuni; Kushihata,Fumiki; Watanabe,Jota; Tohyama,Taiji; Inoue,Hitoshi; Sugita,Atsuro; Takada,Yasutsugu

doi:10.3892/ol.2016.4815

Localized 18F-fluorodeoxyglucose uptake at the pancreatic head during remission phase of autoimmune pancreatitis: A case report

Authors:
- Yoshikuni Yonenaga
- Fumiki Kushihata
- Jota Watanabe
- Taiji Tohyama
- Hitoshi Inoue
- Atsuro Sugita
- Yasutsugu Takada
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Affiliations: Department of Hepatobiliary‑Pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791‑0295, Japan, Pathology Division, Ehime University Hospital, Toon, Ehime 791‑0295, Japan
Published online on: July 6, 2016 https://doi.org/10.3892/ol.2016.4815
Pages: 1801-1805
Copyright: © Yonenaga et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Autoimmune pancreatitis (AIP) is a unique form of pancreatitis, histopathologically characterized by dense lymphoplasmacytic infiltration and fibrosis of the pancreas with obliterative phlebitis. AIP is associated with a good response to steroid therapy. Differentiation between AIP and pancreatic cancer to determine a preoperative diagnosis is often challenging, despite the use of various diagnostic modalities, including computed tomography (CT), magnetic resonance imaging and endoscopic retrograde cholangiopancreatography. It has been reported that 18F‑fluorodeoxyglucose (18F‑FDG)‑positron emission tomography (PET)/CT may be a useful tool for distinguishing between the two diseases. In the present case report, a 71‑year‑old male patient presented with a well‑circumscribed, solitary, nodular and homogenous 18F‑FDG uptake at the pancreatic head, while receiving maintenance steroid therapy in the remission phase of AIP; preoperatively, the patient had been strongly suspected of having pancreatic cancer. Pathological examination revealed post‑treatment relapse of AIP. The present case highlights the diagnostic and management difficulties with AIP in the remission phase. In certain cases, it remains challenging to differentiate the two diseases, even using the latest modalities.

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