Evaluation of "pancreatic mass". No clinical history available.
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There is diffuse enlargement of the pancreas with loss of definition of pancreatic clefts ("sausage" pancreas). The pancreas shows globally decreased T1 signal intensity and diffusion restriction with high DWI signal and low ADC signal, as well as narrowing of the main pancreatic duct. The findings are suggestive of autoimmune pancreatitis.
Autoimmune pancreatitis is a IgG4-related sclerosing disease. Abdominal manifestations may be apparent in the pancreas, biliary tree, gallbladder, retroperitoneum, kidney and prostate, in which tissue fibrosis with obliterative phlebitis is pathologically induced. There were no relevant MRI findings in the other abdominal organs in this patients.
This patient was lost to follow-up and IgG4 levels could not be measured. The imaging findings remain as a probable diagnosis, since the diagnostic criteria could not be fulfilled.