2018 Volume 66 Issue 2 Pages 151-155
A pancreatic mass was found in a 47-year-old female by abdominal CT. 18F-fluorodeoxyglucose positron emission tomography (FDG PET) showed abnormal uptake in the pancreatic mass as well as in the bilateral hilar region of the chest. Chest CT revealed the presence of bilateral hilar lymphadenopathy (BHL). These findings suggested not only pancreatic carcinoma but also autoimmune pancreatitis (AIP). A pancreatoduodenectomy was performed and the pancreatic lesion was diagnosed as pancreatic carcinoma. Non-caseous granulomas were observed in the peri-pancreatic tissue and regional lymph nodes of the pancreas, and they were thought to be sarcoid-like reactions. Hilar 18F-FDG uptake had vanished on the follow-up PET study ; therefore the result suggested that BHL was also a sarcoid-like reaction. Lymphadenopathy due to sarcoid-like reaction associated with malignancy should be considered in the differentiation between a pancreatic carcinoma and AIP.
