Pancreatic pseudotumor arising in association with Sjögren's syndrome.

A case is presented of an elderly female who was found by imaging to have an enlarged pancreas with narrowed distal common bile duct, thought to be neoplastic. Resection revealed an inflammatory and fibrosing process of the pancreas, suggestive of autoimmune disease. Subsequently she developed dry mouth, enlarged salivary glands, and an enlarged lacrimal gland with typical histology of Sjögren's syndrome. Pathological review of the contralateral lacrimal gland excised 20 years earlier showed similar histology. This case is a rare, but not unique, example of pancreatic pseudotumor associated with Sjögren's syndrome. The increasing use of sophisticated abdominal imaging may result in an increased detection of such pseudotumors. Failure to recognize their real nature can lead to inappropriate surgery.

Cystic adventitial disease of the popliteal artery: a report of two cases and a review of the literature.

Cystic adventitial disease is a rare condition affecting the wall of certain major arteries. The case histories of two patients presenting to the Royal North Shore Hospital are reviewed. Both patients were young men who presented with unilateral incapacitating calf claudication of sudden onset. Lower limb arteriography on each affected leg revealed a peculiar irregularity of the popliteal artery. Each patient had the popliteal artery explored and similar findings were revealed viz: an extensive cyclic lesion occupying the adventitial layer of the popliteal artery. The cysts were found to contain mucoid material. It was not necessary to enter the arterial lumen in either case. As far as can be established both patients have remained asymptomatic after the simple procedure of evacuating mucoid material from the cysts.