case_images: PMC4357679_01
case_images: CT scan showing the typical enlarged (1.97 cm) 'sausage-shaped' pancreas and a double duct sign. DHC = Common bile duct; PD = pancreatic duct.
case_images: crg-0009-0056-g01.jpg
case_images: PMC4357679_01_crg-0009-0056-g01.jpg
case_images: F1
case_images: A CT scan showed a double duct sign without clear delineated tumor, no calcification of the pancreas nor infiltration of the vessels (fig. 1).
case_images: Photomicrograph of elastica van Gieson staining showing chronic inflammation of the pancreas with sclerosis and parenchymal atrophy. Magnification x400.
case_images: crg-0009-0056-g02.jpg
case_images: PMC4357679_01_crg-0009-0056-g02.jpg
case_images: F2
case_images: This one showed chronic periductal inflammation with infiltration of plasma cells, sclerosis, venulitis, parenchymal atrophy (fig. 2, fig. 3a) and strong positive immunohistochemical staining for IgG4 (fig. 3a, b).
case_images: Immunohistochemical staining for IgG4 showing numerous IgG4-positive plasma cells surrounding pancreatic hyperplastic ducts (a; magnification x200) and single positive cells in chronic inflammation (b; magnification x400).
case_images: crg-0009-0056-g03.jpg
case_images: PMC4357679_01_crg-0009-0056-g03.jpg
case_images: F3
case_images: This one showed chronic periductal inflammation with infiltration of plasma cells, sclerosis, venulitis, parenchymal atrophy (fig. 2, fig. 3a) and strong positive immunohistochemical staining for IgG4 (fig. 3a, b).
case_images: CT scan showing a less prominent pancreas (1.68 cm) and resolution of bile duct dilation.
case_images: crg-0009-0056-g04.jpg
case_images: PMC4357679_01_crg-0009-0056-g04.jpg
case_images: F4
case_images: Nevertheless, neither calcification nor tumor mass was found (fig. 4).