2013 Volume 28 Issue 6 Pages 785-791
A 65 year-old-man presented with pancreatic-duct distention and received a medical examination at our department. A pancreatic mass was not detected by US enhanced CT. A four millimeter expansion of the pancreatic duct was observed in the body and tail of the pancreases and low echo domain that had an indistinct and irregular border was identified on the head side by EUS. We took carcinoma in situ into consideration and performed ERCP. The pancreatic duct showed localized stenosis at the head body shift region, and the distal pancreatic duct showed beaded appearance. The cytodiagnosis of the pancreatic juice was negative, and classification of the mass was difficult, but we doubted it was pancreatic cancer based on observations from pancreatic duct imaging and the pancreatoduodenectomy. The pathological findings showed a transition of increased papillosity in the pancreatic duct epithelium. A substitution-related increase of atypical epithelium was equivalent to PanIN3 from PanIN1. Permeation was not apparent.
