• Yaping Luo, Guilan Hu, Yanru Ma, Ning Guo, and Fang Li.
• Department of Nuclear Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, P.R. China.
• Medicine (Baltimore). 2017 Sep 1; 96 (38): e7904e7904.

RationalePancreatic acinar cell carcinoma (ACC) is a rare malignant tumor of exocrine pancreas. It is typically a well-marginated large solid mass arising in a certain aspect of the pancreas. Diffuse involvement of ACC in the pancreas is very rare, and may simulate pancreatitis in radiological findings. We report 2 cases of ACC presenting as diffuse enlargement of the pancreas due to tumor involvement without formation of a distinct mass.Patient ConcernsThe patients consisted of a 41-year-old man with weight loss and a 77-year-old man who was asymptomatic.DiagnosesComputed tomography (CT) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT showed diffuse enlargement of the pancreas forming a sausage-like shape with homogenously increased FDG activity.InterventionsEndoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) biopsy of the pancreatic lesion was performed.OutcomesHistopathology results from the pancreas confirmed the diagnosis of pancreatic ACC.LessonsBecause diffuse enlargement of the pancreas is a common imaging feature of pancreatitis, recognition of this rare morphologic pattern of ACC is important for radiological diagnosis of this tumor.

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