Clinical and imaging features of mass forming chronic pancreatitis / 中华胰腺病杂志

ABSTRACT

Objectives To investigate the clinical and imaging features discriminating mass forming chronic pancreatitis (CP) from pancreatic carcinoma. Methods The clinical, radiologic, laboratory and pathologic profiles of eleven patients with mass forming CP were reviewed retrospectively. Results The patients with mass forming CP were predominantly older, male, and presented with obstructive jaundice or abdominal symptoms. Serum level of CA19-9 was slightly elevated, generally below 100 U/ml, which was lower than that of pancreatic carcinoma. The diagnostic accuracy of B-ultrasound for mass forming CP was only 18.2% and it could only be the screening method; the diagnostic accuracy of CT was 45.5%, and the main CT features included dilation of main pancreatic duct and the branches, as well as pancreatic pseudocysts or calcification. The findings of MRCP and EUS were irregular dilation of main pancreatic duct and common bile duct, which were similar to pancreatic carcinoma. ERCP could provide imaging characteristics of biliary and pancreatic duct, and the nature of obstruction, the stricture and dilation of biliary and pancreatic duct. When combined with CT scan, ERCP was useful for differentiation from pancreatic head cancer. According to histopathology, a few mass forming CP was autoimmune pancreatitis. Conclusions Mass forming CP is associated with clinical and radiologic features that are similar to those of pancreatic carcinoma. It is necessary to carefully evaluating clinical and imaging findings, laboratory findings and histopathological examinations.