대한췌장담도학회

CASE 1 : Hb 13.8 g/dL, WBC 6000/uL, PLT 358000/uL, AST 346 IU/L, ALT 536 IU/L, ALP 330 IU/L, Total bilirubin 0.81 mg/L, CRP 7.42 mg/L, Amylase 90 U/L, Lipase 234 IU/L, CA 19-9 0.3 U/mL, CEA 1.6 ng/mL, IgG 1415mg/dL, IgG4 4.3mg/dL CASE 2 : Hb 11.0g/dL, WBC 4000/uL, PLT 288000/uL, AST 227 IU/L, ALT 212 IU/L, ALP 585 IU/L, GGT 1973 IU/L, Total bilirubin 5.95mg/dL, CRP 10.57 mg/L, Amylase 108 U/L, Lipase 67 IU/L, CA 19-9 66.9 U/mL, CEA 4.6 ng/mL, IgG 1206 mg/dL, IgG4 78.0 mg/dL.

CASE 1 : Segmental luminal narrowing at mid CBD CASE 2 : Segmental luminal narrowing at distal CBD.

CASE 1 : Distended gallbladder, mild dilatation of both IHD and CBD with abrupt luminal narrowing at mid to distal CBD. Suspicious diffuse poor enhanced enlarged pancreas with diffuse minimal dilatation of main pancreatic duct, mild peripancreatic fat infiltration. About 1.5 cm-sized enhancing nodular lesion at duodenum 2nd & 3rd portion, DDx. exophytic pancreatic head lesion. About 5 cm-sized hypodense lesion at lower pole of left kidney. CASE 2 :Ill-defined subtle low density lesion in pancreas head with diffusion restriction, causing CBD dilatation. Diffuse edematous change of the pancreas, mainly in pancreas tail, with irregular MPD dilatation.

CASE 1 : Common bile duct, endoscopic biopsy; Tiny fragments of stromal tissue with mild lymphocytic infiltration. CASE 2 : Pancreas, core biopsy; Chronic pancreatitis with 1. lobular destruction with lymphoplasmacytic infiltration 2. fibroblastic activation with fibrosis 3. no evidence fibrin thrombi 4. IgG4 count: up to 25/HPF ; consistent with Autoimmune pancreatitis, type 1