Autoimmune Pancreatitis Accompanied by Eosinophilic Cholecystitis Diagnosed After Surgery: Report of a Case with Histopathological, Radiological, and Clinical Approach

Autoimmune pancreatitis (AIP) is a special type of chronic pancreatitis that has in - creasingly been recognized in recent years. We reported a case of AIP which involved mainly the head of the pancreas and the common bile duct, presenting with the features of an accompanying eosinophilic cholecystitis. A 39-year-old woman presented with jaundice, weight loss, and abdom - inal pain. Radiological examination, together with clinical findings proposed the diagnosis of pan - creatic carcinoma. The patient underwent pancreaticoduodenectomy and gross examination of the specimen revealed a firm, mass-like enlargement at the head of the pancreas. Histological findings were characterized by diffuse lymphoplasmacytic infiltration with marked interstitial fibrosis and focal acinar atrophy, obliterative phlebitis of the pancreatic veins, and perineural inflammatory in - filtration. Inflammatory component involving the gallbladder was mainly composed of eosinophilic leucocytes. Unfortunately, soon after the operation, the patient started to bleed at the site of gas - troenterostomy. Twenty days later, pulmonary thromboemboli developed and the patient died. AIP, which can readily be mistaken for pancreatic carcinoma, may be treated with systemic steroids, if rec - ognized preoperatively. Pathological examination is critical in the evaluation of such cases.