以红斑、结节为首发表现的胰腺性脂膜炎合并胰管结石1例

Pancreatic duct stones with pancreatic panniculitis as the first symptom: a case report

报告1例以红斑、结节为首发表现的胰腺性脂膜炎合并胰管结石。患者男,78岁。双小腿红斑、结节伴触痛4天。皮肤科查体:双小腿可见散在约蚕豆至钱币大小红斑、结节,伴触痛。皮损病理:表皮大致正常,病变主要位于皮下脂肪,脂肪小叶内可见广泛脂肪坏死,周围见嗜碱性细胞团块、混合炎细胞及鬼影细胞。上腹部增强CT:主胰管结石,伴相邻胰颈部及体尾部主胰管扩张。诊断:胰腺性脂膜炎合并胰管结石。转肝胆外科行经腹胰管结石取石术后皮损消退,随访2年未复发。

A 78-year-old male presented with erythema and nodules on both lower extremities for four days. The skin lesions manifested as sporadic erythema and nodules on both legs with tenderness. Biopsy demonstrated extensive fat necrosis in the subcutaneous fat layer, surrounded by basophilic cell lumps, mixed inflammatory cells and ghost cells. Upper abdominal enhanced CT revealed main pancreatic duct stones with dilation of the adjacent main pancreatic duct. After transferred to hepatobiliary surgery, he underwent surgery to have pancreatic duct stones removed.The lesions gradually recovered without recurrence.He was diagnosed with pancreatic panniculitis and pancreatic duct stones.