Lactoferrin amyloid presenting as a mural nodule in a pancreatic cystic lesion prompting pancreatoduodenectomy: a case report

BMC Gastroenterology

Sadhna Dhingra¹  Carlos A. Farinas²  Katherine A. Baugh³  William E. Fisher³  George Van Buren 2nd³  Svetang Desai⁴ 

[1] Department of Pathology and Immunology, Baylor College of Medicine, 1 Baylor Plaza, MS BCM315, 77030, Houston, TX, USA;Department of Radiology, Baylor College of Medicine, Houston, TX, USA;Department of Surgery, Baylor College of Medicine, Houston, TX, USA;Gastroenterology Consultants, Houston, TX, USA;

关键词: Pancreas;    Amyloid;    Mucinous cyst;    Mural nodule;    Case report;   

DOI  :  10.1186/s12876-021-01641-8

来源: Springer

【 摘 要 】

BackgroundAmyloid 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 reportWe 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.ConclusionsWe 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.

【 授权许可】

CC BY