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. 2012 Jun 27;32(4):1133–1158. doi: 10.1148/rg.324115143

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Figure 19a — AIP in a 77-year-old man experiencing abdominal pain, weight loss, and jaundice. (a) Axial contrast-enhanced multidetector CT image shows a hypoattenuating mass in the pancreatic head (arrow). (b, c) Axial contrast-enhanced multidetector (b) and coronal reformatted (c) CT images show the pancreatic body and tail, which are slightly enlarged (arrow in b). Partial obliteration of the pancreatic outline and mild prominence of the main pancreatic duct (arrowheads) are also seen, findings indicative of pancreatic adenocarcinoma. (d, e) Axial PET/CT images show mild to moderate heterogeneous FDG uptake within the pancreatic head (arrow in d) and the rest of the body and tail (arrow in e), a finding indicative of a diffuse low-grade process, such as AIP. Serum CA 19-9 levels were not elevated, and endoscopic US–guided biopsy results were inconclusive. Corticosteroid therapy resulted in a favorable clinical and radiologic response.

Figure 19b — AIP in a 77-year-old man experiencing abdominal pain, weight loss, and jaundice. (a) Axial contrast-enhanced multidetector CT image shows a hypoattenuating mass in the pancreatic head (arrow). (b, c) Axial contrast-enhanced multidetector (b) and coronal reformatted (c) CT images show the pancreatic body and tail, which are slightly enlarged (arrow in b). Partial obliteration of the pancreatic outline and mild prominence of the main pancreatic duct (arrowheads) are also seen, findings indicative of pancreatic adenocarcinoma. (d, e) Axial PET/CT images show mild to moderate heterogeneous FDG uptake within the pancreatic head (arrow in d) and the rest of the body and tail (arrow in e), a finding indicative of a diffuse low-grade process, such as AIP. Serum CA 19-9 levels were not elevated, and endoscopic US–guided biopsy results were inconclusive. Corticosteroid therapy resulted in a favorable clinical and radiologic response.