Fig. 3
From: Abdominal manifestations of IgG4-related disease: a pictorial review
A patient with a history of mucosa-associated lymphoid tissue (MALT) lymphoma, presenting with raised serum IgG4 and diagnosis of AIP on endoscopic ultrasound (EUS)-guided biopsy. a Axial T2 fat saturated (FS) turbospin echo image shows intermediate to high T2 signal within the pancreas (arrows), but extensive low T2 signal peripancreatic tissue (*). There is diffuse narrowing of the distal pancreatic duct. b Axial T1FS post-contrast arterial phase initially shows reduced enhancement of the peripancreatic tissue (*) compared to the pancreas (arrows). c Axial T1FS post-contrast equilibrium phase showing delayed enhancement of the peripancreatic tissue. d The pancreas and extrapancreatic soft tissue shows marked restricted diffusion with high signal on diffusion-weighted imaging—B800 (arrows), a typical finding in AIP. e The tissue demonstrates corresponding low signal on the ADC map (arrows). f Only the extrapancreatic soft tissue shows high-grade FDG uptake (arrows), a finding which was felt to be atypical for lymphoma