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Lymphoplasmacytic sclerosing pancreatitis forming a localized mass: a variant form of autoimmune pancreatitis
- Source :
- Journal of Gastroenterology. 42:650-656
- Publication Year :
- 2007
- Publisher :
- Springer Science and Business Media LLC, 2007.
-
Abstract
- To elucidate the correlation of autoimmune pancreatitis (AIP) and mass-forming pancreatitis, in which a localized mass is formed in the pancreas.Nine cases of mass-forming pancreatitis were divided into two groups, one consisting of cases that met the histological diagnostic criteria for AIP by the Japan Pancreas Society (JPS) and the other consisting of cases which did not. Histological findings, immunohistological findings, and pancreatograms were compared between these groups.Six cases met the histological criteria of JPS (group A) and the other three did not (group B). In the mass-forming portion in group A, the wall of the pancreatic duct showed marked thickening. However, the epithelium was well preserved, and dilatation of the branch ducts or protein plugs were rarely observed. All cases showed marked obliterative phlebitis. The IgG4 labeling index (LI) was 25% or more in all but one case. In the portion other than the mass, the lobular structure was well preserved and the IgG4 LI was less than 10%. The pancreatogram showed localized stenosis or obstruction at the site of the mass associated with a normal-appearing main pancreatic duct in the remaining portion. In group B, histological findings typical of chronic pancreatitis with dilated branch ducts and protein plugs were observed. Obliterative phlebitis was not confirmed. The IgG4 LI in the mass-forming portion was low (2.3%-11.1%).There exists a subgroup of AIP showing localized mass formation and stenosis or obstruction of the main pancreatic duct with prominent obliterative phlebitis associated with a normal ductal segment.
- Subjects :
- Adult
CD4-Positive T-Lymphocytes
Male
medicine.medical_specialty
CD4-CD8 Ratio
CD8-Positive T-Lymphocytes
Gastroenterology
Autoimmune Diseases
Diagnosis, Differential
Surgical oncology
Internal medicine
medicine
Humans
Aged
Retrospective Studies
Autoimmune pancreatitis
Cholangiopancreatography, Endoscopic Retrograde
business.industry
Middle Aged
Hepatology
Prognosis
medicine.disease
Leukemia, Lymphocytic, Chronic, B-Cell
Magnetic Resonance Imaging
Colorectal surgery
Antibodies, Anti-Idiotypic
medicine.anatomical_structure
Pancreatitis
Immunoglobulin G
Variant form
Female
Tomography, X-Ray Computed
business
Pancreas
Abdominal surgery
Subjects
Details
- ISSN :
- 14355922 and 09441174
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Journal of Gastroenterology
- Accession number :
- edsair.doi.dedup.....3c193cdb5cb15a1e47531707db250913