Icicle sign: autoimmune pancreatitis

Shankar, Abhinaya; Srinivas, Sripriya; Kalyanasundaram, S.

doi:10.1007/s00261-019-02323-6

Cited by 3 publications

(2 citation statements)

References 3 publications

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“…Imaging of the pancreatic duct: A duct penetrating sign of skipped narrowing of the main pancreatic duct (MPD) is a useful finding differentiating AIP from PDAC[ 24 , 26 , 27 , 29 - 31 ]. Stenosis of the pancreatic duct caused by periductal fibrosis is commonly observed in AIP; it resembles the tapering of the tip of an icicle and is called an "icicle sign"[ 32 , 33 ]. Linear enhancement along the MPD is often observed in AIP.…”

Section: Diagnosismentioning

confidence: 99%

Challenges for clinicians treating autoimmune pancreatitis: Current perspectives

Kim¹,

Lee²,

Chon³

2023

World J Clin Cases

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Autoimmune pancreatitis (AIP) is a rare disease clinically characterized by obstructive jaundice, unintentional weight loss, acute pancreatitis, focal pancreatic mass, and diabetes. AIP is classified into two subtypes - type 1 and type 2 - according to pathological findings, clinical features, and serology test results, but some cases may be defined as type not otherwise in the absence of pathological findings and inflammatory bowel disease. To address the differences in diagnostic criteria by country, standard diagnostic criteria for AIP were proposed in 2011 by an international consensus of expert opinions. Differential diagnosis of AIP from pancreatic ductal adenocarcinoma is important but remains challenging for clinicians. Fortunately, all subtypes of AIP show dramatic response to steroid treatment. This review discusses the current perspectives on the diagnosis and management of AIP in clinical practice.

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Section: Diagnosismentioning

confidence: 99%

Challenges for clinicians treating autoimmune pancreatitis: Current perspectives

Kim¹,

Lee²,

Chon³

2023

World J Clin Cases

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show abstract

“…This is called the “ icicle sign” (the MPD could penetrate the mass without complete occlusion, and the pancreatic duct stenosis may taper within the mass), which is caused by periductal fibrosis causing extrinsic compression and ductal narrowing in the affected part of the pancreas. This sign has a specificity of up to 95% and an accuracy of 88% for diagnosing AIP[ 102 , 103 ].…”

Section: Auxiliary Information That May Differentiate Pancreatic Massesmentioning

confidence: 99%

Pancreatic cancer, autoimmune or chronic pancreatitis, beyond tissue diagnosis: Collateral imaging and clinical characteristics may differentiate them

Tornel-Avelar,

Velarde Ruiz-Velasco,

Pelaez-Luna

2023

World J Gastrointest Oncol

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Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal malignancies and is developing into the 2 nd leading cause of cancer-related death. Often, the clinical and radiological presentation of PDAC may be mirrored by other inflammatory pancreatic masses, such as autoimmune pancreatitis (AIP) and mass-forming chronic pancreatitis (MFCP), making its diagnosis challenging. Differentiating AIP and MFCP from PDAC is vital due to significant therapeutic and prognostic implications. Current diagnostic criteria and tools allow the precise differentiation of benign from malignant masses; however, the diagnostic accuracy is imperfect. Major pancreatic resections have been performed in AIP cases under initial suspicion of PDAC after a diagnostic approach failed to provide an accurate diagnosis. It is not unusual that after a thorough diagnostic evaluation, the clinician is confronted with a pancreatic mass with uncertain diagnosis. In those cases, a re-evaluation must be entertained, preferably by an experienced multispecialty team including radiologists, pathologists, gastroenterologists, and surgeons, looking for disease-specific clinical, imaging, and histological hallmarks or collateral evidence that could favor a specific diagnosis. Our aim is to describe current diagnostic limitations that hinder our ability to reach an accurate diagnosis among AIP, PDAC, and MFCP and to highlight those disease-specific clinical, radiological, serological, and histological characteristics that could support the presence of any of these three disorders when facing a pancreatic mass with uncertain diagnosis after an initial diagnostic approach has been unsuccessful.

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Effective apparent diffusion coefficient parameters for differentiation between mass-forming autoimmune pancreatitis and pancreatic ductal adenocarcinoma

et al. 2020

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Icicle sign: autoimmune pancreatitis

Cited by 3 publications

References 3 publications

Challenges for clinicians treating autoimmune pancreatitis: Current perspectives

Challenges for clinicians treating autoimmune pancreatitis: Current perspectives

Pancreatic cancer, autoimmune or chronic pancreatitis, beyond tissue diagnosis: Collateral imaging and clinical characteristics may differentiate them

Effective apparent diffusion coefficient parameters for differentiation between mass-forming autoimmune pancreatitis and pancreatic ductal adenocarcinoma

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