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
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical ImagingAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Xanthogranulomatous pancreatitis presents as a solid tumor mass: a case report.J Korean Med Sci. 2011; 26: 583-586
- Xanthogranulomatous pancreatitis mimicking a malignant solid tumour.BMJ Case Rep. 2016; ([bcr2015209934])
- Xanthogranulomatous pancreatitis associated with a mucinous cystic neoplasm.Pathol Int. 2015; 66: 174-176
- Xanthogranulomatous pancreatitis mimicking a malignant cystic tumor of the pancreas: report of a case.Surg Today. 2011; 41: 1310-1313
- Xanthogranulomatous change appearing in the pancreas cyst wall.Pancreas. 1993; 8: 649-651
- Xanthogranulomatous pancreatitis: mass lesion of the pancreas simulating pancreatic carcinoma—a report of two cases.Indian J Pathol Microbiol. 2004; 47: 36-38
- Xanthogranulomatous pancreatitis associated with intraductal papillary mucinous tumor.AJR. 2005; 185: 704-707
- Xanthogranulomatous pancreatitis combined with intraductal papillary mucinous carcinoma in situ.Korean Med Sci. 2010; 25: 1814-1817
- Xanthogranulomatous lesion of the pancreas mimicking pancreatic cancer.Med Sci Monit. 2008; 14: CS130-CS133
- Xanthogranulomatous pancreatitis mimicking a pancreatic cancer on CT and MRI: a case report and literature review.iMRI. 2016; 20: 185-190
- Xanthogranulomatous pancreatitis by duodenum-preserving pancreatic head resection.Hepatobiliary Pancreat Dis Int. 2010; 9: 216-218
- Xanthogranulomatous inflammation of the peripancreatic region mimicking pancreatic cystic neoplasm.Intern Med. 2009; 48: 1881-1884
- Resected xanthogranulomatous pancreatitis.J Hepatobiliary Pancreat Surg. 2008; 15: 240-242
- Xanthogranulomatous pancreatic abscess secondary to acute pancreatitis: two case reports.Hepatogastroenterology. 2007; 54: 1648-1651
- The xanthogranulomatous process.Pathol Res Pract. 1988; 183: 395-402
- Xanthogranulomatous cholecystitis: clinical, sonographic, and CT findings in 26 patients.AJR. 2000; 174: 979-983
- Xanthogranulomatous pyelonephritis.Arch Pathol Lab Med. 2011; 135: 671-674
- Xanthogranulomatous cholecystitis: a radiological study of 12 cases and review of the literature.Abdom Imaging. 1996; 21: 456-460
- US findings of xanthogranulomatous cholecystitis.Clin Radiol. 1998; 53: 290-292
- Xanthogranulomatous cholecystitis versus gallbladder carcinoma.Radiology. 1997; 203: 10-12
- Simultaneous xanthogranulomatous cholecystitis and primary adenocarcinoma of gallbladder.Histopathology. 1988; 12: 672-675
- Cystic lesions of the pancreas.AJR. 2011; 196: W668-W677
- The revised Atlanta classification of acute pancreatitis: its importance for the radiologist and its effect on treatment.Radiology. 2012; 262: 751-764
- Cyst fluid analysis in the differential diagnosis of pancreatic cystic lesions: a pooled analysis.Gastrointest Endosc. 2005; 62: 383-389
- EUS-FNA predicts 5-year survival in pancreatic endocrine tumors.Gastrointest Endosc. 2009; 70: 907-914
- Pancreatic neuroendocrine tumor with cystlike changes: evaluation with MDCT.AJR. 2013; 200: W283-W290
- Pancreatic endocrine tumor: radiologic-clinicopathologic correlation.Radiographics. 2010; 30: 1445-1464
- Primary cystic neoplasms of the pancreas: neoplastic disorders of emerging important—current state-of-the-art and unanswered questions.J Gastrointest Surg. 2003; 7: 417-428
- Solidpseudopapillary tumor of the pancreas: a typically cystic carcinoma of low malignant potential.Semin Diagn Pathol. 2000; 17: 66-80
- Solid pseudopapillary tumor of the pancreas: typical and atypical manifestations.AJR. 2006; 187: W178-W186
Article info
Publication history
Published online: May 23, 2017
Accepted:
May 22,
2017
Received in revised form:
May 21,
2017
Received:
March 10,
2017
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
