Clinical study of @entity1689 with focal irregular narrowing of the main pancreatic duct and mass formation: comparison with XXXX showing diffuse irregular narrowing of the main pancreatic duct.

@entity1 @entity788 @entity82 @entity1087 @entity1689 @entity14501 @entity4754 @entity158 @entity230 @entity792
INTRODUCTION: Main pancreatic duct (MPD)-narrowed @entity1689 ( @entity1689 ) may be an @entity792 . It also has been called autoimmune @entity788 and sclerosing @entity788 . It is unclear whether cases with focal pancreatographic changes are part of the same clinical entity as cases with diffuse MPD changes. AIM AND METHODOLOGY: We reviewed seven cases of @entity1689 ( @entity1689 ) with focal narrowing of the main pancreatic duct (MPD), evidenced by endoscopic retrograde cholangiopancreatography (ERCP), and swelling of one or two segments of the @entity788 , evidenced by ultrasonography (US) /computed tomography (CT), and indicated the clinicopathologic features of focal-type MPD-narrowed @entity1689 . RESULTS: The @entity1 group comprised six @entity1 and one @entity1 , and their age range was 28-75 years, with a mean of 63.7 years. Affected sites were in the head in two @entity1 , the body in one @entity1 , the tail in one @entity1 , and the body and tail in three @entity1 ; ERP showed narrowing in six @entity1 and obstruction in one. Stricture of the lower portion of the common bile duct (CBD) that caused obstructive @entity1087 was shown by ERC in two cases in which the @entity788 head was affected. In all six @entity1 , a dynamic study by CT or MRI homogeneously showed delayed enhancement of involved segments of the @entity788 . Serum levels of pancreatic enzyme were elevated in five @entity1 , but only one subject had @entity788 -like @entity158 . Serological evidence suggestive of @entity792 was detected in only three @entity1 with @entity4754 (> or =2.0 g/dL) or positive titers of antinuclear antibody (ANA; > or =80). Histological assessment was available for five @entity1 , who characteristically had dense lymphocytic or plasmocytic infiltration with severe @entity82 that caused luminal narrowing. The clinical, serologic, and histologic findings as described above were comparable to those for 12 @entity1689 @entity1 with diffuse narrowing of the MPD, diagnosed during the same period. Surgical resection was performed in 5 @entity1 , in 2 of whom a similar inflammatory process recurred in the remnant head of the @entity788 , whereas @entity788 no longer developed in the other 3 @entity1 . One @entity1 was initially treated with @entity230 , with clinical remission, although there was neither @entity4754 nor positive ANA. CONCLUSION: These results indicate that @entity1689 with focal narrowing of the @entity14501 is part of the same clinical spectrum as @entity1689 with diffuse narrowing of the MPD, and whether the distribution is diffuse or focal seems to be related to the stage or the extent of the disease. It is therefore important to recognize the possible existence of this focal variant to avoid unnecessary surgery.
