AI Article Synopsis

  • Xanthogranulomatous inflammation is a chronic condition marked by groups of foamy histiocytes, fibrosis, and various inflammatory cells, and is notably rare in the pancreas compared to its occurrence in the gallbladder or kidney.
  • A case study involves a 77-year-old woman who experienced a month of epigastric pain, leading to imaging that revealed a cystic mass in the pancreatic tail and a splenic abscess, initially suspected to be a pancreatic pseudocyst or tumor.
  • After various imaging techniques suggested potential malignancy, a distal pancreatectomy with splenectomy was performed, ultimately revealing xanthogranulomatous pancreatitis without malignant cells.

Article Abstract

Xanthogranulomatous inflammation is a chronic inflammatory reaction microscopically characterized by aggregation of foamy histiocytes, fibrous tissue, and infiltration of various inflammatory cells. In contrast to xanthogranulomatous inflammation in the gallbladder or kidney, xanthogranulomatous pancreatitis is rare. We herein present a case of xanthogranulomatous pancreatitis in a patient who underwent distal pancreatectomy with splenectomy under preoperative suspicion of a pancreatic pseudocyst or pancreatic tumor. A 77-year-old woman with a 1 month history of epigastric pain, anorexia, and general fatigue was admitted to our hospital. Contrast-enhanced computed tomography revealed a cystic mass with ill-defined margins at the pancreatic tail together with a splenic abscess. Contrast-enhanced endoscopic ultrasound detected a hyperechoic cystic lesion at the tail of the pancreas with heterogeneous internal echogenicity, and part of the intra-cystic content was enhanced by the contrast agent. Endoscopic retrograde cholangiopancreatography showed a cystic lesion at the tail of the pancreas that continued into the main pancreatic duct, and the main pancreatic duct was slightly narrowed downstream of the cystic lesion. Pancreatic juice cytology revealed suspicious cells, leading to the possibility of intraductal papillary mucinous carcinoma. Distal pancreatectomy with splenectomy was performed, and the histopathological diagnosis was xanthogranulomatous pancreatitis with no malignant findings.

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Source
http://dx.doi.org/10.1007/s12328-024-01930-1DOI Listing

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