Abstract
Since chronic pancreatitis can mimic pancreatic cancer, the differential diagnosis of these two entities is an important clinical challenge. A survey focusing on the misdiagnosis of chronic pancreatitis and pancreatic carcinoma was conducted by the Research Committee of Intractable Diseases of the Pancreas, supported by the Japanese Ministry of Health, Labor and Welfare. A survey of 29 institutions, from 2001 to 2011, revealed that 125 patients with chronic pancreatitis underwent surgical resection after an initial preoperative diagnosis of pancreatic carcinoma, and 26 patients with pancreatic carcinoma underwent observation only because these were thought to have chronic pancreatitis. A second detailed survey of 23 institutions, showed that 78 and 16 patients were misdiagnosed with pancreatic cancer and chronic pancreatitis, respectively. At the time of preoperative diagnosis, 12 patients with benign disease had class IV or V on Endoscopic Ultrasound-guided Fine Needle Aspiration cytology (EUS-FNA) and/or brush cytology from the pancreatic duct. Few cytological false positives have been previously reported in the literature. Further studies are necessary to evaluate preoperative cytology in patients with chronic pancreatitis and pancreatic carcinoma to avoid unnecessary surgery.
