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Xanthogranulomatous pancreatitis: A review of the imaging characteristics of this rare and often misdiagnosed lesion of the pancreas

      Highlights

      • XGP is a very rare form of chronic pancreatitis and in a majority of cases is misdiagnosed as a primary pancreatic neoplasm.
      • XGP can present as a solid or a cystic lesion and typically shows hypoattenuation on CT, high T2 signal, and low T1 signal.
      • XGP is often FDG-avid on PET and can show increased FDG uptake throughout or at the periphery—corresponding to wall uptake.
      • A relatively thick and enhancing wall is usually identified which has an infiltrative appearance about half of the time.
      • XGP should be considered when a pancreatic mass has an infiltrative appearing wall and involves surrounding structures.

      Abstract

      Xanthogranulomatous pancreatitis (XGP) is an extremely rare cause of a cystic pancreatic mass. The pathophysiology of this process is not entirely clear but likely results from a combination of duct obstruction, infection, and repeated hemorrhage. It is difficult to differentiate this inflammatory lesion from a cystic neoplasm and, therefore, in the majority of cases XGP is misdiagnosed as a neoplasm on preoperative imaging. In this report, we describe a case of XGP, the imaging characteristics of XGP, and a differential diagnosis for a cystic pancreatic lesion.

      Keywords

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