1例误诊为胰腺癌的肿块型胰腺炎病例报道

A Case Report of Mass-Forming Pancreatitis Misdiagnosed as Pancreatic Cancer

摘要: 肿块型胰腺炎作为一种特殊类型的慢性胰腺炎，表现为胰腺内的炎性肿块，但由于肿块型胰腺炎和胰腺癌在临床表现、影像学表现上极为相似，临床上误诊率较高。本文报道病例中，结合其临床表现、影像学检查、实验室检查均提示胰腺癌，但术中冰冻活检证实为慢性胰腺炎。为提升鉴别诊断准确率，对于临床上肿块型胰腺炎和胰腺癌鉴别困难的病例，应充分结合多种检查手段，如CT、MRI、PET/CT、基因检测、内镜超声、超声内镜引导下细针穿刺抽吸活检等，基于多方位检查的综合评估对两者的鉴别诊断具有重要意义。

Abstract: Mass-forming pancreatitis is a special type of chronic pancreatitis characterized by inflammatory masses within the pancreas. Since mass-forming pancreatitis and pancreatic carcinoma share highly similar clinical manifestations and imaging features, the clinical misdiagnosis rate remains relatively high. In the case reported in this article, clinical manifestations, imaging examinations and laboratory tests all suggested pancreatic carcinoma, while intraoperative frozen-section biopsy confirmed the diagnosis of chronic pancreatitis. To improve the accuracy of differential diagnosis, for clinically challenging cases that are difficult to distinguish between mass-forming pancreatitis and pancreatic carcinoma, multiple examination modalities should be fully combined, including CT, MRI, PET/CT, genetic testing, endoscopic ultrasonography, and endoscopic ultrasound-guided fine-needle aspiration biopsy. Comprehensive evaluation based on multi-dimensional examinations is of great significance for the differential diagnosis of the two diseases.