FEB 7TH 2020
Piotr Polaków has shared a new Clinical case
IgG4-related disease (IgG4RD) is a complex, immune-mediated illness characterized by lymphoplasmacytic infiltration of multiple organs, accompanied by an elevated serum IgG level . Pancreatic involvement has been termed autoimmune pancreatitis (AIP) and aortitis -Immunoglobulin G4-Related Aortitis.
60-year-old man was admitted to our hospital because of body weight loss, upper quadrant abdoman pain.
CT with contast administration was performed.
. Diffuse enlargement of the pancreas with loss of definition of pancreatic clefts, so-called "sausage-like appearance".
Also inflammatory mass is seen, it lies anterior and lateral to the aorta, sparing the posterior aspect and not causing aortic displacement. Axial nonenhanced CT images show an irregular retroperitoneal mass.
MD Piotr Polaków
SP ZOZ Wojewódzki Szpital Zespolony im. J. Śniadeckiego in Bialystok
Minimal peripancreatic fat stranding, with inflammatory thickening confined to the peripancreatic region. Peripancreatic rim of low attenuation "halo" is well seen in the pancreatic phase.
On contrast-enhanced CT (CECT), the pancreas is enlarged, with featureless border and effacement of the lobular contour
Well-delimited but irregular soft-tissue periaortic mass, which extends from the level of the renal arteries to the iliac vessels
The mass usually lies anterior and lateral to the aorta, sparing the posterior aspect and not causing aortic displacement.
Inflamatory changes progresses through the retroperitoneum to envelop the ureters and IVC. he right proximal hydroureter is secondary to distal encasement of the ureter
Autoimmune pancreatitis (AIP) with abdominal aortitis, a rare extrapancreatic manifestation of AIP, was diagnosed.
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