[IPMC of the pancreas with enlarged para-aortic lymph nodes with a high accumulation of FDG-PET:a case report].

Abstract

A 74-year-old man was admitted for evaluation of a pancreatic tumor. Abdominal CT revealed a multilocular cystic tumor with thickened septal walls and an enhanced mural nodule in the head of the pancreas, as well as enlarged para-aortic lymph nodes. FDG-PET revealed FDG accumulation in the nodule and in the para-aortic nodes. The tumor was diagnosed as intraductal papillary mucinous carcinoma (IPMC) with para-aortic lymph node metastases. After 2 courses of chemotherapy with gemcitabine and nab-paclitaxel, the tumor decreased slightly in size, but the lymph nodes did not change. Surgery was then performed. Intraoperative pathology examination confirmed that the para-aortic lymph nodes had only inflammatory swelling. Accordingly, pylorus-preserving pancreaticoduodenectomy was performed. Histopathology examination revealed atypical cells without invasion, and IPMC (TisN0M0;stage 0) was diagnosed. It is thus important for selection of the appropriate treatment approach to determine if enlarged para-aortic lymph nodes are benign or malignant.

• Authors: Atsuro Fujinaga, Teijiro Hirashita, Yusuke Itai, Hiroaki Nakanuma, Kazuhiro Tada, Takashi Masuda, Yuichi Endo, Yukio Iwashita, Masayuki Ohta, Masafumi Inomata
• Journal: Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology (Nihon Shokakibyo Gakkai Zasshi) Vol. 116 Issue 9 Pg. 747-753 ( 2019) ISSN: 0446-6586 [Print] Japan
• PMID: 31511461 (Publication Type: Case Reports, Journal Article)

Chemical References

• Fluorodeoxyglucose F18

Topics

• Aged
• Fluorodeoxyglucose F18 (metabolism)
• Humans
• Lymph Node Excision
• Lymph Nodes
• Male
• Pancreas
• Pancreatic Neoplasms (diagnosis)
• Pancreaticoduodenectomy