Lymphoplasmacytic sclerosing pancreatitis with cholangitis: A variant of primary sclerosing cholangitis extensively involving pancreas

doi:10.1016/0046-8177(91)90087-6

Human Pathology

Volume 22, Issue 4, April 1991, Pages 387-395

https://doi.org/10.1016/0046-8177(91)90087-6 Get rights and content

Abstract

Pancreatic involvement in primary sclerosing cholangitis (PSC) is an extremely rare condition, and its pathologic features are poorly documented. We report two cases of an unusual lymphoplasmacytic sclerosing inflammatory disease involving the total pancreas, common bile duct, gallbladder, and, in one patient, the lip. Two elderly men presented with waxing and waning obstructive jaundice, and exhibited radiologic and ultrasonographic findings highly suggestive of pancreatic carcinoma. Gross appearance of the pancreas showed firm and mass-like enlargement with regional lymph node swelling. Histologic findings were characterized by diffuse lymphoplasmacytic infiltration with marked interstitial fibrosis and acinar atrophy, obliterated phlebitis of the pancreatic veins, and involvement of the portal vein. Similar inflammatory processes involved the bile duct and the gallbladder. Lymphoplasmacytic sclerosing pancreatitis with cholangitis is thought to be a more appropriate term for this condition, of which a similar lesion has been previously noted in a single case of “PSC involving pancreas”. Differences in age, radiologic appearance, and the negative history of ulcerative colitis exist, but the two cases in this study could be considered as a variant of PSC extensively involving pancreas, which can readily be mistaken for pancreatic carcinoma.

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Original contributionLymphoplasmacytic sclerosing pancreatitis with cholangitis: A variant of primary sclerosing cholangitis extensively involving pancreas

Abstract

Gastroenterology

Am J Surg

Gastroenterology

Am J Surg

Lancet

Gastroenterology

Primary sclerosing cholangitis: A review of its clinical features, cholangiography, and hepatic histology

Gut

Current concepts: Primary sclerosing cholangitis

N Engl J Med

Primary sclerosing cholangitis

Arch Intern Med

Primary sclerosing cholangitis: Complete gross and histologic reversal after long-term steroid therapy

Am J Gastroenterol

Original contribution
Lymphoplasmacytic sclerosing pancreatitis with cholangitis: A variant of primary sclerosing cholangitis extensively involving pancreas