scholarly journals Type 1 Autoimmune Pancreatitis with Imaging Appearance Similar to That of Malignant Cystic Tumor

2019 ◽  
Vol 13 (2) ◽  
pp. 265-270
Author(s):  
Takeshi Ezaki ◽  
Atsuhiro Masuda ◽  
Hideyuki Shiomi ◽  
Takashi Nakagawa ◽  
Keitaro Sofue ◽  
...  
Keyword(s):  
Plasma Cell ◽  
Autoimmune Pancreatitis ◽  
Cystic Lesion ◽  
Pancreatic Head ◽  
Mural Nodule ◽  
Cell Infiltration ◽  
Cystic Neoplasm ◽  
Plasma Cell Infiltration ◽  
Type 1 Autoimmune Pancreatitis

A 79-year-old man was admitted with asymptomatic elevation of liver enzymes and tumor markers. Abdominal contrast-enhanced computed tomography demonstrated swelling of the pancreatic head, and additional blood test showed raised IgG4 levels. Histological examination by endoscopic ultrasonography (EUS)-guided fine needle aspiration for pancreatic head mass revealed storiform fibrosis and IgG4-positive plasma cell infiltration. We diagnosed this case as type 1 autoimmune pancreatitis (AIP). In addition, there was a cystic lesion in the pancreatic body apart from the pancreatic head mass. A mural nodule in the multilocular cyst was detected by EUS, and there was positive uptake of fluorodeoxyglucose in positron emission tomography/magnetic resonance imaging. The preoperative diagnosis of this cystic lesion was intraductal papillary mucinous carcinoma, and distal pancreatomy was performed. Histopathological findings showed various sizes of retention cysts caused by IgG4-positive plasma cell infiltration around the pancreatic branch ducts. The mural nodule was a fibrotic mass with diffuse infiltration of IgG4-positive cells. This cystic lesion mimicking malignant cystic neoplasm occurred in relation to AIP. This case provided important information helping to understand the mechanism of formation of mural nodules in multilocular cysts in patients with type 1 AIP.

Autoimmune pancreatitis is closely associated with gastric ulcer presenting with abundant IgG4-bearing plasma cell infiltration

2004 ◽  
Vol 59 (4) ◽  
pp. 506-511 ◽  
Author(s):  
Akihiro Shinji ◽  
Kenji Sano ◽  
Hideaki Hamano ◽  
Hiroshi Unno ◽  
Mana Fukushima ◽  
...  
Keyword(s):  
Gastric Ulcer ◽  
Plasma Cell ◽  
Autoimmune Pancreatitis ◽  
Cell Infiltration ◽  
Plasma Cell Infiltration

scholarly journals Cystic Lesions in Autoimmune Pancreatitis

2015 ◽  
Vol 9 (3) ◽  
pp. 366-374 ◽  
Author(s):  
Macarena Gompertz ◽  
Claudia Morales ◽  
Hernán Aldana ◽  
Jaime Castillo ◽  
Zoltán Berger
Keyword(s):  
Autoimmune Pancreatitis ◽  
Cystic Lesion ◽  
Pancreatic Head ◽  
Pancreatic Tissue ◽  
Steroid Treatment ◽  
Cystic Neoplasm ◽  
Blood Levels ◽  
Cystic Lesions ◽  
Lymphoplasmacytic Infiltration ◽  
One Year

Autoimmune pancreatitis (AIP) can be chronic or recurrent, but frequently completely reversible after steroid treatment. A cystic lesion in AIP is a rare finding, and it can mimic a pancreatic cystic neoplasm. Difficulties in an exact diagnosis interfere with treatment, and surgery cannot be avoided in some cases. We report the history of a 63-year-old male presenting with jaundice and pruritus. AIP was confirmed by imaging and elevated IgG4 blood levels, and the patient completely recovered after corticosteroid therapy. One year later, he presented with a recurrent episode of AIP with elevated IgG4 levels, accompanied by the appearance of multiple intrapancreatic cystic lesions. All but 1 of these cysts disappeared after steroid treatment, but the remaining cyst in the pancreatic head was even somewhat larger 1 year later. Pancreatoduodenectomy was finally performed. Histology showed the wall of the cystic lesion to be fibrotic; the surrounding pancreatic tissue presented fibrosis, atrophy and lymphoplasmacytic infiltration by IgG4-positive cells, without malignant elements. Our case illustrates the rare possibility that cystic lesions can be part of AIP. These pseudocysts appear in the pancreatic segments involved in the autoimmune disease and can be a consequence of the local inflammation or related to ductal strictures. Steroid treatment should be initiated, after which these cysts can completely disappear with recovery from AIP. Surgical intervention may be necessary in some exceptional cases.

scholarly journals IgG4-positive plasma cell infiltration in the diagnosis of autoimmune pancreatitis

2006 ◽  
Vol 20 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Lizhi Zhang ◽  
Kenji Notohara ◽  
Michael J Levy ◽  
Suresh T Chari ◽  
Thomas C Smyrk
Keyword(s):  
Plasma Cell ◽  
Autoimmune Pancreatitis ◽  
Cell Infiltration ◽  
Plasma Cell Infiltration

scholarly journals CALCB splice region pathogenic variants leading to plasma cell neurotropic enrichment in type 1 autoimmune pancreatitis

2017 ◽  
Vol 8 (2) ◽  
pp. e2591-e2591 ◽  
Author(s):  
Qi-cai Liu ◽  
Falin Chen ◽  
Chao-yang Wu ◽  
Feng Gao ◽  
Ze-hao Zhuang ◽  
...  
Keyword(s):  
Plasma Cell ◽  
Autoimmune Pancreatitis ◽  
Pathogenic Variants ◽  
Type 1 Autoimmune Pancreatitis

scholarly journals Coexisting Mucinous Cystic Neoplasm of the Pancreas and Type 1 Autoimmune Pancreatitis

2019 ◽  
Vol 53 (2) ◽  
pp. 125-128 ◽  
Author(s):  
Mee-Jeong Kim ◽  
Tae Jun Song ◽  
Hyoung Jung Kim ◽  
Song-Cheol Kim ◽  
Myung-Hwan Kim ◽  
...  
Keyword(s):  
Autoimmune Pancreatitis ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Type 1 Autoimmune Pancreatitis
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