胰腺癌误诊为自身免疫性胰腺炎一例并文献复习  

Transverse Colon Lymphoma Being Misdiagnosed as Autoimmune Pancreatitis:One Case Report and Literature Review

作　　者：邓卫平[1] 陈松[2] 马娟[1] 

机构地区：[1]广东省人民医院/广东省医学科学院消化科,广东省广州市510080 [2]汕头市澄海区人民医院消化科

出　　处：《中国全科医学》2014年第16期1920-1923,共4页Chinese General Practice

基　　金：国家自然科学基金资助项目(81001112);广州市科技局珠江科技新星项目(2012J2200019)

摘　　要：胰腺癌早期常无症状,确诊较难,且治疗效果欠佳,患者预后差,有时易与自身免疫性胰腺炎(AIP)混淆。AIP是特殊类型的慢性胰腺炎,以慢性上腹痛为主要临床表现,易被误诊为胰腺癌而进行不必要的手术治疗。近年来,随着临床医生对AIP的认识增加,AIP误诊为胰腺癌的现象有所减少,而弥漫型胰腺癌误诊为AIP的情况则时有发生。本文报道了1例影像学检查高度怀疑AIP患者,经糖皮质激素治疗无效,最终经胰腺穿刺活检确诊为胰腺癌。提示临床医生对于可疑患者,在考虑疑难疾病的同时不可忽视常见病,应尽早进行病理学检查以免贻误治疗。Pancreatic cancer is often mild and may be even asymptomatic in early stage so that it is diagnosed difficultly and responds poor to treatment and prognosis. Sometimes it is difficult to identify pancreatic cancer from autoimmune pancreatitis （AIP） . AIP, a special type of chronic pancreatitis with chronic epigastric pain as its clinical manifestations, is so easily misdi- agnosed as pancreatic cancer that patients may have unnecessary surgery. Recently, the clinical physicians have had more and more knowledge of AIP, the misdiagnosis of pancreatic cancer as AlP is reduced than before, but diffuse type being misdiagnosed as pancreatic cancer occasionally occurs. The article reports a case who was highly suspected as AIP by imaging examination and after failure of glucocorticoid treatment finally diagnosed as pancreatic cancer by needle biopsy. The report is to suggest that for suspicious cases, the clinical physicians should not overlook the possibilities of common disease in diagnosing complicated incura- ble diseases and should carry out pathological examination earlier in case of delayed therapy.

关 键 词：胰腺肿瘤 胰腺炎 慢性 自身免疫性胰腺炎 病理学 临床 

分 类 号：R576[医药卫生—消化系统] R735.9[医药卫生—内科学]