Abstract
Abstract
Background
Amyloid deposition in pancreas is rare. Lactoferrin amyloid deposition has not been reported in pancreas, till date. Presence of enhancing mural nodule in a cyst on imaging is a worrisome feature for malignancy, and warrants surgical resection in a surgically fit candidate, as per Fukuoka guidelines for management of cystic lesions in pancreas.
Case report
We report a case of localized amyloidosis presenting as a mural nodule in a 1.6 cm cyst located in the head of pancreas, which led to pancreatoduodenectomy in a 69 year old woman. Histological evaluation revealed a simple mucinous cyst with localized lactoferrin amyloid deposition corresponding to the mural nodule identified on imaging.
Conclusions
We report the first case of localized lactoferrin amyloid deposition in pancreas that presented as a mural nodule in a cystic lesion and prompted pancreatoduodenectomy. This unique case illustrates that on rare occasion mural nodule in a cyst can be benign. It adds amyloid deposition to the differential diagnosis of mural nodules in pancreatic cystic lesions seen on imaging.
Publisher
Springer Science and Business Media LLC
Subject
Gastroenterology,General Medicine
Reference21 articles.
1. Kelly JW. The alternative conformations of amyloidogenic proteins and their multi-step assembly pathways. Curr Opin Struct Biol. 1998;8(1):101–6.
2. Benson MD. Amyloidosis. In: Scriver CR, Beaudet AK, Sly WS, Valle D, editors. The metabolic and molecular bases of inherited disease. New York: McGraw-Hill; 1995. p. 4159–91.
3. Tan SY, Pepys MB. Amyloidosis. Histopathology. 1994;25(5):403–14.
4. Onur MR, Yalnız M, Poyraz AK, et al. Pancreatic islet cell amyloidosis manifesting as a large pancreas. Korean J Radiol. 2012;13(1):94–7.
5. Segovia GC, Quilez Barrenechea JI, Vidales Aréchaga L, et al. Pancreatic involvement in primary amyloidosis: radiologic findings. Eur Radiol. 2002;12(4):774–8.