Groove pancreatitis, a masquerading yet distinct clinicopathological entity: Analysis of risk factors and differentiation

Veeral M. Oza, Jacob M. Skeans, Peter Muscarella, Jon P. Walker, Brett C. Sklaw, Kevin M. Cronley, Samer El-Dika, Benjamin Swanson, Alice Hinton, Darwin L. Conwell, Somashekar G. Krishna

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Objectives Our objective was to delineate predictive factors differentiating groove pancreatitis (GP) from other lesions involving the head of the pancreas (HOP). Methods A case-control study of patients older than 10 years was performed comparing patients with GP to those with other surgically resected HOP lesions. Results Thirteen patients with GP (mean ± SD age, 51.9 ± 10.5 years; 11 males [84.6%]), all with a history of smoking (mean, 37.54 ± 17.8 pack-years), were identified. Twelve patients (92.3%) had a history of heavy alcohol drinking (heavy alcohol [EtOH]). The mean lesion size was 2.6 ± 1.1 cm, and the CA 19-9 was elevated (>37 IU/mL) in 5 patients (45.5%). The most common histopathologic condition was duodenal wall cyst with myofibroblastic proliferation and changes of chronic pancreatitis in the HOP. Univariate analysis revealed decreasing age, male sex, weight loss, nausea/vomiting, heavy EtOH, smoking, and a history of chronic pancreatitis were predictive of GP. A multivariate analysis among smokers demonstrated that weight loss (P = 0.006; odds ratio, 11.96; 95% confidence interval, 2.1-70.2), and heavy EtOH (P < 0.001; odds ratio, 82.2; 95% confidence interval, 9.16-738.1) were most predictive of GP. Compared to pancreatic adenocarcinoma (n = 183), weight loss and heavy EtOH remained predictive of GP. Conclusion Groove pancreatitis in the HOP is associated with a history of heavy EtOH and weight loss. In the absence of these symptoms, it is essential to rule out a malignant lesion.

Original languageEnglish (US)
Pages (from-to)901-908
Number of pages8
JournalPancreas
Volume44
Issue number6
DOIs
StatePublished - Aug 25 2015
Externally publishedYes

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Pancreatitis
Weight Loss
Pancreas
Chronic Pancreatitis
Smoking
Odds Ratio
Confidence Intervals
Alcohol Drinking
Nausea
Vomiting
Case-Control Studies
Cysts
Adenocarcinoma
Multivariate Analysis
Alcohols

Keywords

  • Abbreviations
  • chronic pancreatitis
  • CI - confidence interval
  • CP - chronic pancreatitis
  • CT - computed tomography
  • EUS - endoscopic ultrasound
  • FCS - fully conditional specification
  • FNA - fine needle aspiration
  • GP - groove pancreatitis
  • groove pancreatitis
  • HOP - head of pancreas
  • OR - odds ratio
  • pancreatic malignancy
  • pancreaticoduodenal

ASJC Scopus subject areas

  • Hepatology
  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Medicine(all)

Cite this

Groove pancreatitis, a masquerading yet distinct clinicopathological entity : Analysis of risk factors and differentiation. / Oza, Veeral M.; Skeans, Jacob M.; Muscarella, Peter; Walker, Jon P.; Sklaw, Brett C.; Cronley, Kevin M.; El-Dika, Samer; Swanson, Benjamin; Hinton, Alice; Conwell, Darwin L.; Krishna, Somashekar G.

In: Pancreas, Vol. 44, No. 6, 25.08.2015, p. 901-908.

Research output: Contribution to journalArticle

Oza, VM, Skeans, JM, Muscarella, P, Walker, JP, Sklaw, BC, Cronley, KM, El-Dika, S, Swanson, B, Hinton, A, Conwell, DL & Krishna, SG 2015, 'Groove pancreatitis, a masquerading yet distinct clinicopathological entity: Analysis of risk factors and differentiation', Pancreas, vol. 44, no. 6, pp. 901-908. https://doi.org/10.1097/MPA.0000000000000351
Oza, Veeral M. ; Skeans, Jacob M. ; Muscarella, Peter ; Walker, Jon P. ; Sklaw, Brett C. ; Cronley, Kevin M. ; El-Dika, Samer ; Swanson, Benjamin ; Hinton, Alice ; Conwell, Darwin L. ; Krishna, Somashekar G. / Groove pancreatitis, a masquerading yet distinct clinicopathological entity : Analysis of risk factors and differentiation. In: Pancreas. 2015 ; Vol. 44, No. 6. pp. 901-908.
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abstract = "Objectives Our objective was to delineate predictive factors differentiating groove pancreatitis (GP) from other lesions involving the head of the pancreas (HOP). Methods A case-control study of patients older than 10 years was performed comparing patients with GP to those with other surgically resected HOP lesions. Results Thirteen patients with GP (mean ± SD age, 51.9 ± 10.5 years; 11 males [84.6{\%}]), all with a history of smoking (mean, 37.54 ± 17.8 pack-years), were identified. Twelve patients (92.3{\%}) had a history of heavy alcohol drinking (heavy alcohol [EtOH]). The mean lesion size was 2.6 ± 1.1 cm, and the CA 19-9 was elevated (>37 IU/mL) in 5 patients (45.5{\%}). The most common histopathologic condition was duodenal wall cyst with myofibroblastic proliferation and changes of chronic pancreatitis in the HOP. Univariate analysis revealed decreasing age, male sex, weight loss, nausea/vomiting, heavy EtOH, smoking, and a history of chronic pancreatitis were predictive of GP. A multivariate analysis among smokers demonstrated that weight loss (P = 0.006; odds ratio, 11.96; 95{\%} confidence interval, 2.1-70.2), and heavy EtOH (P < 0.001; odds ratio, 82.2; 95{\%} confidence interval, 9.16-738.1) were most predictive of GP. Compared to pancreatic adenocarcinoma (n = 183), weight loss and heavy EtOH remained predictive of GP. Conclusion Groove pancreatitis in the HOP is associated with a history of heavy EtOH and weight loss. In the absence of these symptoms, it is essential to rule out a malignant lesion.",
keywords = "Abbreviations, chronic pancreatitis, CI - confidence interval, CP - chronic pancreatitis, CT - computed tomography, EUS - endoscopic ultrasound, FCS - fully conditional specification, FNA - fine needle aspiration, GP - groove pancreatitis, groove pancreatitis, HOP - head of pancreas, OR - odds ratio, pancreatic malignancy, pancreaticoduodenal",
author = "Oza, {Veeral M.} and Skeans, {Jacob M.} and Peter Muscarella and Walker, {Jon P.} and Sklaw, {Brett C.} and Cronley, {Kevin M.} and Samer El-Dika and Benjamin Swanson and Alice Hinton and Conwell, {Darwin L.} and Krishna, {Somashekar G.}",
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TY - JOUR

T1 - Groove pancreatitis, a masquerading yet distinct clinicopathological entity

T2 - Analysis of risk factors and differentiation

AU - Oza, Veeral M.

AU - Skeans, Jacob M.

AU - Muscarella, Peter

AU - Walker, Jon P.

AU - Sklaw, Brett C.

AU - Cronley, Kevin M.

AU - El-Dika, Samer

AU - Swanson, Benjamin

AU - Hinton, Alice

AU - Conwell, Darwin L.

AU - Krishna, Somashekar G.

PY - 2015/8/25

Y1 - 2015/8/25

N2 - Objectives Our objective was to delineate predictive factors differentiating groove pancreatitis (GP) from other lesions involving the head of the pancreas (HOP). Methods A case-control study of patients older than 10 years was performed comparing patients with GP to those with other surgically resected HOP lesions. Results Thirteen patients with GP (mean ± SD age, 51.9 ± 10.5 years; 11 males [84.6%]), all with a history of smoking (mean, 37.54 ± 17.8 pack-years), were identified. Twelve patients (92.3%) had a history of heavy alcohol drinking (heavy alcohol [EtOH]). The mean lesion size was 2.6 ± 1.1 cm, and the CA 19-9 was elevated (>37 IU/mL) in 5 patients (45.5%). The most common histopathologic condition was duodenal wall cyst with myofibroblastic proliferation and changes of chronic pancreatitis in the HOP. Univariate analysis revealed decreasing age, male sex, weight loss, nausea/vomiting, heavy EtOH, smoking, and a history of chronic pancreatitis were predictive of GP. A multivariate analysis among smokers demonstrated that weight loss (P = 0.006; odds ratio, 11.96; 95% confidence interval, 2.1-70.2), and heavy EtOH (P < 0.001; odds ratio, 82.2; 95% confidence interval, 9.16-738.1) were most predictive of GP. Compared to pancreatic adenocarcinoma (n = 183), weight loss and heavy EtOH remained predictive of GP. Conclusion Groove pancreatitis in the HOP is associated with a history of heavy EtOH and weight loss. In the absence of these symptoms, it is essential to rule out a malignant lesion.

AB - Objectives Our objective was to delineate predictive factors differentiating groove pancreatitis (GP) from other lesions involving the head of the pancreas (HOP). Methods A case-control study of patients older than 10 years was performed comparing patients with GP to those with other surgically resected HOP lesions. Results Thirteen patients with GP (mean ± SD age, 51.9 ± 10.5 years; 11 males [84.6%]), all with a history of smoking (mean, 37.54 ± 17.8 pack-years), were identified. Twelve patients (92.3%) had a history of heavy alcohol drinking (heavy alcohol [EtOH]). The mean lesion size was 2.6 ± 1.1 cm, and the CA 19-9 was elevated (>37 IU/mL) in 5 patients (45.5%). The most common histopathologic condition was duodenal wall cyst with myofibroblastic proliferation and changes of chronic pancreatitis in the HOP. Univariate analysis revealed decreasing age, male sex, weight loss, nausea/vomiting, heavy EtOH, smoking, and a history of chronic pancreatitis were predictive of GP. A multivariate analysis among smokers demonstrated that weight loss (P = 0.006; odds ratio, 11.96; 95% confidence interval, 2.1-70.2), and heavy EtOH (P < 0.001; odds ratio, 82.2; 95% confidence interval, 9.16-738.1) were most predictive of GP. Compared to pancreatic adenocarcinoma (n = 183), weight loss and heavy EtOH remained predictive of GP. Conclusion Groove pancreatitis in the HOP is associated with a history of heavy EtOH and weight loss. In the absence of these symptoms, it is essential to rule out a malignant lesion.

KW - Abbreviations

KW - chronic pancreatitis

KW - CI - confidence interval

KW - CP - chronic pancreatitis

KW - CT - computed tomography

KW - EUS - endoscopic ultrasound

KW - FCS - fully conditional specification

KW - FNA - fine needle aspiration

KW - GP - groove pancreatitis

KW - groove pancreatitis

KW - HOP - head of pancreas

KW - OR - odds ratio

KW - pancreatic malignancy

KW - pancreaticoduodenal

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