A 67-year-old man with T2DM and hyperlipidemia was evaluated for unintentional weight loss of 28 lb (12.7 Kg) and increasing fasting blood glucose values over the past six months. A CT scan revealed diffuse enlargement of the pancreas with peripheral hypo-enhancement but no discrete mass. Soft tissue surrounded the infrarenal abdominal aorta, extended along the common iliac arteries, and obstructed the left ureter, causing hydronephrosis.
The patient was referred for evaluation of possible malignancy. Laboratory investigations Hemoglobin: 11.7 g/dL Mean corpuscular volume: 84.1 μm 3 White blood cell count: 6800/μL Erythrocyte sedimentation rate: 11 mm/h Fasting glucose: 134 mg/dL Alkaline phosphatase: 70 U/L Aspartate aminotransferase: 19 U/L Creatinine: 1.6 mg/dL carbohydrate antigen 19-9: 17.1 U/mL Immunoglobulin G, total: 1530 mg/dL Immunoglobulin G, subclass 4: 391 mg/dL Fine-needle…
