A Rare Presentation of Sarcoidosis as a Pancreatic Head Mass
Sarcoidosis is a multisystem granulomatous syndrome of unknown etiology with noncaseating epithelioid granulomas being the pathognomonic pathological finding. Sarcoidosis most commonly involves the lungs and involvement of the gastrointestinal (GI) tract is uncommon. Pancreatic sarcoidosis is very r...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Pulmonology |
| Online Access: | http://dx.doi.org/10.1155/2017/7037162 |
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| author | Shruti Mony Pradnya D. Patil Rebekah English Ananya Das Daniel A. Culver Tanmay S. Panchabhai |
| author_facet | Shruti Mony Pradnya D. Patil Rebekah English Ananya Das Daniel A. Culver Tanmay S. Panchabhai |
| author_sort | Shruti Mony |
| collection | DOAJ |
| description | Sarcoidosis is a multisystem granulomatous syndrome of unknown etiology with noncaseating epithelioid granulomas being the pathognomonic pathological finding. Sarcoidosis most commonly involves the lungs and involvement of the gastrointestinal (GI) tract is uncommon. Pancreatic sarcoidosis is very rare, especially when it is the presenting feature of sarcoidosis and can masquerade as pancreatic cancer. Tissue infiltration in pancreatic sarcoidosis can lead to either a diffuse nodular appearance or a mass-like lesion. We present an interesting case of a 47-year-old woman with a 10-pack-year history of smoking who presented with sharp epigastric pain, weight loss, and elevated lipase level. CT and MRI imaging showed a 4 cm × 5 cm heterogeneous pancreatic mass with a dilated pancreatic duct and peripancreatic lymphadenopathy. Endoscopic ultrasound guided FNA revealed noncaseating granulomas with no evidence of malignancy or atypical infection. CT of the chest revealed bilateral mediastinal and hilar adenopathy with calcification, without any parenchymal abnormalities, and her angiotensin-converting enzyme level was elevated at 170 U/L. The clinical picture pointed to the diagnosis of pancreatic sarcoidosis. Given the severity of gastrointestinal symptoms related to pancreatic sarcoidosis, prednisone therapy at 0.5 mg/kg/day was initiated with complete resolution of symptoms at 8 weeks. |
| format | Article |
| id | doaj-art-8ba74c2d2c304c93a6a39d001d4000b6 |
| institution | Kabale University |
| issn | 2090-6846 2090-6854 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pulmonology |
| spelling | doaj-art-8ba74c2d2c304c93a6a39d001d4000b62025-08-20T03:37:41ZengWileyCase Reports in Pulmonology2090-68462090-68542017-01-01201710.1155/2017/70371627037162A Rare Presentation of Sarcoidosis as a Pancreatic Head MassShruti Mony0Pradnya D. Patil1Rebekah English2Ananya Das3Daniel A. Culver4Tanmay S. Panchabhai5Department of Internal Medicine, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USADepartment of Hospital Medicine, Medicine Institute, Cleveland Clinic, Cleveland, OH, USANorton Thoracic Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USAArizona Center for Digestive Diseases and St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USADepartment of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USANorton Thoracic Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USASarcoidosis is a multisystem granulomatous syndrome of unknown etiology with noncaseating epithelioid granulomas being the pathognomonic pathological finding. Sarcoidosis most commonly involves the lungs and involvement of the gastrointestinal (GI) tract is uncommon. Pancreatic sarcoidosis is very rare, especially when it is the presenting feature of sarcoidosis and can masquerade as pancreatic cancer. Tissue infiltration in pancreatic sarcoidosis can lead to either a diffuse nodular appearance or a mass-like lesion. We present an interesting case of a 47-year-old woman with a 10-pack-year history of smoking who presented with sharp epigastric pain, weight loss, and elevated lipase level. CT and MRI imaging showed a 4 cm × 5 cm heterogeneous pancreatic mass with a dilated pancreatic duct and peripancreatic lymphadenopathy. Endoscopic ultrasound guided FNA revealed noncaseating granulomas with no evidence of malignancy or atypical infection. CT of the chest revealed bilateral mediastinal and hilar adenopathy with calcification, without any parenchymal abnormalities, and her angiotensin-converting enzyme level was elevated at 170 U/L. The clinical picture pointed to the diagnosis of pancreatic sarcoidosis. Given the severity of gastrointestinal symptoms related to pancreatic sarcoidosis, prednisone therapy at 0.5 mg/kg/day was initiated with complete resolution of symptoms at 8 weeks.http://dx.doi.org/10.1155/2017/7037162 |
| spellingShingle | Shruti Mony Pradnya D. Patil Rebekah English Ananya Das Daniel A. Culver Tanmay S. Panchabhai A Rare Presentation of Sarcoidosis as a Pancreatic Head Mass Case Reports in Pulmonology |
| title | A Rare Presentation of Sarcoidosis as a Pancreatic Head Mass |
| title_full | A Rare Presentation of Sarcoidosis as a Pancreatic Head Mass |
| title_fullStr | A Rare Presentation of Sarcoidosis as a Pancreatic Head Mass |
| title_full_unstemmed | A Rare Presentation of Sarcoidosis as a Pancreatic Head Mass |
| title_short | A Rare Presentation of Sarcoidosis as a Pancreatic Head Mass |
| title_sort | rare presentation of sarcoidosis as a pancreatic head mass |
| url | http://dx.doi.org/10.1155/2017/7037162 |
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