抄録
Dynamic CT and ERCP play an important role in the differential diagnosis between pancreatic cancer and chronic pancreatitis. However, we experienced a case of cancer of the pancreatic head that it was difficult to distinguish from chronic pancreatitis by the two examinations. The pancreatic tumor in this case on CT was enhanced identically to the surrounding parenchyma of the pancreas in both early and delayed phases. ERCP showed the smooth stenosis of the common bile duct and the stenosis of the main pancreatic duct with the visualization of the branches from the stenosis, suggesting chronic pancreatitis. Abdominal anginography revealed the obstruction of the pancreatic arcades and seemed to be a useful tool on the differential diagnosis between pancreatic cancer and chronic pancreatitis. In addition, the brushing cytology under ERP that demonstrated class V in this case should be performed in such a difficult case of distinguishing between these two diseases.
