Focal chronic pancreatitis mimicking pancreatic head carcinoma: are there suggestive features on ultrasound?
Bibliographic record
Abstract
OBJECTIVE: Painless jaundice is one of the most common presentations of pancreatic head cancer. Chronic pancreatitis can also occasionally present with a mass or mass-like process in the pancreatic head, with the subsequent development of jaundice. In this retrospective review, we evaluate the clinical and imaging features of 22 patients presenting with painless jaundice, initially thought to have pancreatic head cancer and ultimately proven to have chronic focal pancreatitis, to determine whether there are any features on cross-sectional imaging to suggest the correct diagnosis. METHODS: Patients (n = 22) were identified from the medical and imaging records of more than 400 patients with an original diagnosis of pancreatic cancer who were seen at our institution from 1995 to 2003. Of the patients, 17 were men and 5 were women (age range 25 to 82 years, mean age 54 years). RESULTS: Initial ultrasound showed a large, hypoechoic, well-defined mass in the pancreatic head, varying in size from 3 to 7.5 cm; 14 of 22 masses were > 5 cm in maximal diameter. Diagnosis of focal pancreatitis was proven by surgical pathology in 14 cases and suggested by percutaneous biopsy in 3 cases; for all patients, prolonged imaging follow-up (at least 1 year) showed no disease progression or evidence of malignancy. The mean follow-up in our study group was 31 months (range 12 to 72 months). CONCLUSION: Male sex, large size of the pancreatic head mass (mean diameter 5.5 cm), and lack of atrophy of the pancreatic body and tail were the only features associated with chronic inflammation rather than neoplasm as an explanation for a pancreatic head mass. Chronic pancreatitis should be considered in the differential diagnosis of focal pancreatic masses, even in the absence of supporting clinical evidence.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".