Autoimmune pancreatitis mimicking pancreatic cancer

Robison, Lindsay; Canon, Cheri L.; Varadarajulu, Shyam; Eloubeidi, Mohamad A.; Vickers, Selwyn M.; Wilcox, C. Mel

doi:10.1007/s00534-010-0321-1

Cited by 14 publications

(12 citation statements)

References 51 publications

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“…AIP commonly presents with obstructive jaundice or weight loss, similar to ductal adenocarcinoma [8]. In addition, AIP can form a mass-like lesion in the head of the pancreas on imaging studies [9,10].…”

Section: Introductionmentioning

confidence: 99%

Fine Needle Aspirate of Autoimmune Pancreatitis (Lymphoplasmacytic Sclerosing Pancreatitis): Cytomorphologic Characteristics and Clinical Correlates

Holmes

Hruban²,

Wolfgang³

et al. 2012

Acta Cytologica

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Objective: Autoimmune pancreatitis (AIP) is an inflammatory, IgG4-associated condition that often overlaps clinically and radiographically with pancreatic ductal adenocarcinoma. We reviewed our institutional experience with fine needle aspiration (FNA) cytology in patients subsequently diagnosed with AIP. Study Design: A retrospective review was conducted of FNA results correlating to all surgical pancreatic specimens diagnosed as AIP or lymphoplasmacytic sclerosing pancreatitis from 1984 to 2011. Results: AIP was diagnosed in 15 cases by surgical resection and in 2 by combined clinical findings and nondiagnostic biopsies. Of 20 aspirates from 17 patients, 1 was diagnosed as malignant, 1 as neoplasm (mucinous), 10 as atypical, 5 as benign, and 3 as scant or nondiagnostic. Of the 10 aspirates diagnosed as atypical, 1 was suspicious for malignancy, 1 could not exclude neuroendocrine neoplasm, 1 was markedly atypical, and 7 demonstrated scattered ductal atypia. Common morphologic features included hypocellularity, focal-to-marked ductal epithelial atypia, fibrous tissue fragments, and a smear background lacking red blood cells. Conclusion: On FNA, AIP most often leads to an ‘atypical’ cytopathologic interpretation and rarely may be diagnosed as adenocarcinoma. Thus, caution is warranted to avoid overdiagnosis on FNA when a mass lesion is reported in a patient with clinical or radiographic suspicion of AIP.

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Section: Introductionmentioning

confidence: 99%

Fine Needle Aspirate of Autoimmune Pancreatitis (Lymphoplasmacytic Sclerosing Pancreatitis): Cytomorphologic Characteristics and Clinical Correlates

Holmes

Hruban²,

Wolfgang³

et al. 2012

Acta Cytologica

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“…Although typical cases of AIP with diffuse enlargement of the pancreas on CT or MRI could be easily diagnosed, focal AIP with pancreatic mass lesion is sometimes difficult to distinguish from pancreatic carcinoma, in spite of recent advances in imaging tests such as CT, MRI, and PDG-PET [6,8,[34][35][36].…”

Section: Discussionmentioning

confidence: 98%

“…However, later publications showed that the pancreas could also be focally involved by autoimmune pathology, and the patients with focal AIP demonstrated a painless jaundice in the setting of focal pancreatic mass lesion [5][6][7]. Focal AIP is often misdiagnosed as pancreatic carcinoma in spite of recent advances in the development of imaging modalities [6][7][8][9], and Chari et al reported that the diagnosis could not be confirmed without steroid trial, core biopsy, or surgical resection in 30% of AIP [10]. Therefore, the development of noninvasive tests to distinguish AIP from pancreatic carcinoma is crucial.…”

Section: Introductionmentioning

confidence: 96%

Novel quantitative perfusion analysis with contrast-enhanced harmonic EUS for differentiation of autoimmune pancreatitis from pancreatic carcinoma

Imazu

Kanazawa

Mori

et al. 2012

Scandinavian Journal of Gastroenterology

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“…21 As pancreatic cancer is the fourth leading cause of malignancy-related deaths in the United States, we speculate that there will be increasing demand for EUS-guided tissue acquisition. 22 It is our opinion that more education and training is needed to propagate the appropriate use of EUS-FNA for tissue procurement in patients with suspected pancreatic neoplasms, given its higher sensitivity and specificity versus percutaneous or surgical biopsy options.…”

Section: Discussionmentioning

confidence: 99%