Year 2023 / Volume 115 / Number 12
Letter
Pancreatic cancer detected with 18F-FDG PET/CT in a case of IgG4-related disease

742-744

DOI: 10.17235/reed.2023.9870/2023

Wenpeng Huang, Yongkang Qiu, Aixiang Wang, Lei Kang,

Abstract
We present a case of a 67-year-old male presenting with severe abdominal pain, laboratory tests revealed IgG levels of 63.5 g/L, IgG4 levels of 63.7 g/L, and negative results for ANCA (Anti-Neutrophil Cytoplasmic Antibodies), Hematuria immunofixation electrophoresis, as well as Cold globulin qualitative test. 18F-FDG PET/CT revealed multiple lesions with increased metabolism in the submaxillary saliva gland, intrahepatic bile ducts, prostate, seminal vesicle glands, and the body of the pancreas. Additionally, a circular cystic-solid lesion with metabolic heterogeneity was observed in the head of the pancreas, accompanied by visible dilatation of the pancreatic duct. The diagnostic imaging suggested IgG4-related disease (IgG4-RD), while pancreatic malignancy could not be definitively ruled out. The patient underwent fine-needle aspiration (FNA) biopsies of lung nodules and the prostate gland, all of which were consistent with the diagnosis of IgG4-RD. Additionally, FNA biopsy of a pancreatic lesion is consistent with the diagnosis of pancreatic ductal adenocarcinoma.
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References
[1] Perugino CA, Stone JH. IgG4-related disease: an update on pathophysiology and implications for clinical care[J]. Nat Rev Rheumatol, 2020, 16(12):702-714. DOI: 10.1038/s41584-020-0500-7.
[2] Poddighe D. Autoimmune pancreatitis and pancreatic cancer: Epidemiological aspects and immunological considerations[J]. World J Gastroenterol, 2021, 27(25):3825-3836. DOI: 10.3748/wjg.v27.i25.3825.
[3] Cheng MF, Guo YL, Yen RF, et al. Clinical Utility of FDG PET/CT in Patients with Autoimmune Pancreatitis: a Case-Control Study[J]. Sci Rep, 2018, 8(1):3651. DOI: 10.1038/s41598-018-21996-5.
[4] Tang CYL, Chua WM, Cheng LTJ, et al. 18F-FDG PET/CT Manifestations of IgG4-related Disease[J]. Br J Radiol, 2021, 94(1124):20210105. DOI: 10.1259/bjr.20210105.
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Huang W, Qiu Y, Wang A, Kang L. Pancreatic cancer detected with 18F-FDG PET/CT in a case of IgG4-related disease. 9870/2023


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Publication history

Received: 25/07/2023

Accepted: 31/07/2023

Online First: 04/08/2023

Published: 12/12/2023

Article Online First time: 10 days

Article editing time: 140 days


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