Tumefactive necrobiotic granulomas (Nodulosis) of the pancreas in an adult with long-standing rheumatoid arthritis

Wolfram F.J. Riedlinger, Terry C. Lairmore, Dennis M. Balfe, Louis P. Dehner

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Rheumatoid nodules are well-documented clinical and pathologic lesions in patients with seropositive rheumatoid arthritis (RA). The current report documents the occurrence of rheumatoid nodulosis of the pancreas in an adult woman with a 7-year history of seropositive RA who presented with upper abdominal pain and was found to have multiple masses in the body and tail of the pancreas by imaging studies. An elevated serum pancreatic polypeptide (PP) and the development of new lesions in the pancreas prompted a subsequent distal pancreatectomy. The lesions in the pancreas proved to be necrobiotic palisading and hyalinizing granulomas upon pathologic examination. Also, of interest, elevation of serum PP has been observed in patients with RA and other systemic noninfectious and infectious inflammatory disorders in the absence of a pancreatic or intestinal neuroendocrine neoplasm.

Original languageEnglish
Pages (from-to)207-210
Number of pages4
JournalInternational Journal of Surgical Pathology
Volume13
Issue number2
DOIs
StatePublished - Apr 1 2005

Keywords

  • Hyalinizing granuloma
  • Necrobiotic granuloma
  • Pancreas
  • Pancreatic polypeptide
  • Rheumatoid arthritis
  • Rheumatoid nodule

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