Paraduodenal pancreatitis: a new unifying term and its morphological characteristics

Two inflammatory lesions represent the major differential diagnosis of pancreatic cancer clinically and on imaging: autoimmune (IgG4) pancreatitis and paraduodenal pancreatitis. This latter lesion has been described under various denominations, especially in most early reports by using the term “cystic dystrophy developed in heterotopic pancreas”. Most cases present in young alcoholic males as cystic and inflammatory mass forming lesions centred in the duodenum and the juxtaduodenal pancreatic tissue, predominating in the region of the minor papilla. They may be associated with chronic calcifying pancreatitis. Pathogenetically, key factors are alcohol and anatomical or functional obstruction of the papilla minor.