Histological features of autoimmune pancreatitis and IgG4-related sclerosing cholangitis with a correlation with imaging findings

Notohara, Kenji

doi:10.1007/s10396-021-01148-5

Cited by 3 publications

(4 citation statements)

References 117 publications

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“…In clinical settings, the majority of AIP cases can be identified by imaging. Firstly, diffuse AIP often shows diffuse pancreas enlargement with a reduced "sausage"-like density on computed tomography (CT) images[ 4 ] (Figure 1A ), which is caused by the infiltration of a large number of lymphocytes and the proliferation of fibrous tissue in the lesion sites. The density of pancreatic lesions is uniform, and contrast-enhanced scan often shows moderate enhancement (Figure 1B and C ).…”

Section: To the Editormentioning

confidence: 99%

Diagnostic value of imaging examination in autoimmune pancreatitis

Wang¹,

Peng²,

Xiao³

2022

World J Clin Cases

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Autoimmune pancreatitis (AIP) is a special type of chronic pancreatitis mediated by autoimmunity factors. It can be divided into two categories according to pathological characteristics: Lymphoplasmacytic sclerosing pancreatitis and idiopathic duct-centric pancreatitis. In the clinical setting, the imaging manifestations of some AIP cases are atypical, so it is difficult to distinguish it from general pancreatitis, pancreatic ductal adenocarcinoma, lymphoma, and other malignant disorders. Most importantly, the treatment for and prognosis of these diseases are different. Therefore, a timely correct imaging diagnosis of AIP is key for AIP patients. After that, clinicians can take appropriate treatment measures for those patients, which is helpful for the prognosis of AIP.

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Section: To the Editormentioning

confidence: 99%

Diagnostic value of imaging examination in autoimmune pancreatitis

Wang¹,

Peng²,

Xiao³

2022

World J Clin Cases

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“…The gold standard in the diagnosis of AIP is based on pathological findings. Notohara [8] described in detail the pathological findings and characteristics of AIP. Understanding the clinical features and imaging findings of AIP in relation to the corresponding pathological features contributes to a deeper and more accurate understanding of the pathophysiology of AIP.…”

Section: Pathological Findingsmentioning

confidence: 99%

Encyclopedia of autoimmune pancreatitis: this is all we need

Ohno

Hirooka

2021

J Med Ultrasonics

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“…The lesion distribution of type 1 AIP is also unique. 15 In the biopsy specimens, two components are commonly obtained. The first component is the lobular contours that are well‐preserved and well‐circumscribed despite dense lymphoplasmacytic infiltration (Figure 2a–c ).…”

Section: Introductionmentioning

confidence: 99%

“…The lesion distribution of type 1 AIP is also unique 15 . In the biopsy specimens, two components are commonly obtained.…”

Section: Introductionmentioning

confidence: 99%

Biopsy diagnosis of type 1 autoimmune pancreatitis: Does it bring a conclusion or confusion?

Notohara

2021

DEN Open

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A biopsy‐based diagnosis of type 1 autoimmune pancreatitis (AIP) is now feasible via an endoscopic ultrasound‐guided fine‐needle biopsy, but there are potential issues to address. The benefits of acquiring large tissue samples include more successful immunostaining for Immunoglobulin G4 and more identifications of storiform fibrosis, obliterative phlebitis, and the ductal lesions of type 1 AIP. However, storiform fibrosis may not be present in all the type 1 AIP lesions. An interobserver agreement study revealed only slight‐to‐moderate agreement among pathologists diagnosing the histological findings of type 1 AIP. Potential reasons for disagreement are the different time phases of the inflammation (which result in heterogeneous histological pictures), a focal appearance of the typical histological findings, and the different definitions used by pathologists. We have thus devised guidance for diagnosing type 1 AIP based on biopsy tissues. In this guidance, we define each histological finding of type 1 AIP, for example, storiform fibrosis as a swirling arrangement of inflammatory cells, spindle‐shaped cells, and delicate collagens as a unit. The necessity of elastic stains for identifying obliterative phlebitis is explained, with examples of mimickers. Another important purpose of a biopsy in type 1 AIP cases is differentiation from pancreatic ductal adenocarcinoma (PDAC). In this situation, acinar‐ductal metaplasia observed in type 1 AIP is a mimicker of PDAC and should not be confused. For the resolution of potential disagreements among pathologists, a multi‐disciplinary approach with the collaboration of clinicians, radiologists, and pathologists is necessary to avoid confusion.

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Histological features of autoimmune pancreatitis and IgG4-related sclerosing cholangitis with a correlation with imaging findings

Cited by 3 publications

References 117 publications

Diagnostic value of imaging examination in autoimmune pancreatitis

Diagnostic value of imaging examination in autoimmune pancreatitis

Encyclopedia of autoimmune pancreatitis: this is all we need

Biopsy diagnosis of type 1 autoimmune pancreatitis: Does it bring a conclusion or confusion?

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