The similarity of Type 1 autoimmune pancreatitis to pancreatic ductal adenocarcinoma with significant IgG4-positive plasma cell infiltration

2012 ◽  
Vol 48 (6) ◽  
pp. 751-761 ◽  
Author(s):  
Yuri Fukui ◽  
Kazushige Uchida ◽  
Kimi Sumimoto ◽  
Takeo Kusuda ◽  
Hideaki Miyoshi ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Plasma Cell ◽  
Autoimmune Pancreatitis ◽  
Cell Infiltration ◽  
Ductal Adenocarcinoma ◽  
Plasma Cell Infiltration ◽  
Type 1 Autoimmune Pancreatitis

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 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

Intraductal Tubulopapillary Epithelial Proliferation Associated with Type 1 Autoimmune Pancreatitis

2018 ◽  
Vol 27 (1) ◽  
pp. 83-87 ◽  
Author(s):  
Shinya Fujie ◽  
Hiroyuki Matsubayashi ◽  
Hirotoshi Ishiwatari ◽  
Hiromasa Hazama ◽  
Takaaki Ito ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Autoimmune Pancreatitis ◽  
Fibrous Tissue ◽  
Ductal Adenocarcinoma ◽  
Epithelial Proliferation ◽  
Pancreatic Body ◽  
Gastric Type ◽  
Serum Igg4 ◽  
Type 1 Autoimmune Pancreatitis

A 70-year-old man was referred to our hospital with exacerbation of diabetes. His blood tests showed elevated levels of serum IgG4 and HbA1c. Computed tomography of the pancreatic body demonstrated a weakly enhanced mass, 2 cm in size, with indistinct borders. Magnetic resonance cholangiopancreatography revealed a narrowing of the main pancreatic duct (MPD) at the pancreatic body, a markedly dilated upstream duct, and a slightly dilated downstream duct. Endoscopic ultrasonography demonstrated an iso-hypoechoic heterogeneous mass, protruding and spreading in the pancreatic duct. The histology of a fine needle aspiration sample demonstrated fibrous tissue containing abundant IgG4-positive plasma cells and atypical epithelial cells. The imaging findings and histology were not typical for either pancreatic ductal adenocarcinoma or type 1 autoimmune pancreatitis (AIP), but these were not completely excluded, and a distal pancreatectomy was performed. Histological examination showed an intraductal tubulopapillary epithelial proliferation, which contained cytoplasmic mucin (MUC5AC and MUC6), and severe IgG4-positive lymphoplasmacytic infiltration in the interstitium around the MPD. Next-generation sequencing using DNA extracted from the tumor revealed no mutation of K-ras, GNAS, or TP53. The entire lesion was ultimately diagnosed as AIP with an intraductal tubular and papillary epithelial hyperplasia producing gastric-type mucin. Some recent reports have described AIP development in the background of intraductal papillary mucinous neoplasms, and some have hypothesized a paraneoplastic occurrence of IgG4-related disease. The current case indicates issues in the clinical diagnosis of rare variants of AIP, and raises questions about the relationship between AIP and pancreatic epithelial lesions.

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

S1287 IgG4-Positive Plasma Cell Infiltration in the Digestive Tract Mucosa of Patients with Autoimmune Pancreatitis Is Neither Abundant Nor Specific

2009 ◽  
Vol 136 (5) ◽  
pp. A-229-A-230
Author(s):  
Yann L. Baleur ◽  
Vinciane Rebours ◽  
Yoram Bouhnik ◽  
Pierre Bedossa ◽  
Philippe B. Ruszniewski ◽  
...  
Keyword(s):  
Digestive Tract ◽  
Plasma Cell ◽  
Autoimmune Pancreatitis ◽  
Cell Infiltration ◽  
Plasma Cell Infiltration
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