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Articles de revues sur le sujet « Autoimmune pancreatiti »

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Auteur : Grafiati
Publié le 11 mars 2023

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1

Salahuddin, Ayesha, et Muhammad Wasif Saif. « Pancreatic Tuberculosis or Autoimmune Pancreatitis ». Case Reports in Medicine 2014 (2014) : 1–5. http://dx.doi.org/10.1155/2014/410142.

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Introduction. Isolated pancreatic and peripancreatic tuberculosis is a challenging diagnosis due to its rarity and variable presentation. Pancreatic tuberculosis can mimic pancreatic carcinoma. Similarly, autoimmune pancreatitis can appear as a focal lesion resembling pancreatic malignancy. Endoscopic ultrasound-guided fine needle aspiration provides an effective tool for differentiating between benign and malignant pancreatic lesions. The immune processes involved in immunoglobulin G4 related systemic diseases and tuberculosis appear to have some similarities.Case Report. We report a case of a 59-year-old Southeast Asian male who presented with fever, weight loss, and obstructive jaundice. CT scan revealed pancreatic mass and enlarged peripancreatic lymph nodes. Endoscopic ultrasound-guided fine needle aspiration confirmed the presence ofmycobacterium tuberculosis. Patient also had high immunoglobulin G4 levels suggestive of autoimmune pancreatitis. He was started on antituberculosis medications and steroids. Clinically, he responded to treatment. Follow-up imaging showed findings suggestive of chronic pancreatitis.Discussion. Pancreatic tuberculosis and autoimmune pancreatitis can mimic pancreatic malignancy. Accurate diagnosis is imperative as unnecessary surgical intervention can be avoided. Endoscopic ultrasound-guided fine needle aspiration seems to be the diagnostic test of choice for pancreatic masses. Long-term follow-up is warranted in cases of chronic pancreatitis.
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Zavrtanik, Hana, et Aleš Tomažič. « Is Surgery in Autoimmune Pancreatitis Always a Failure ? » Medicina 59, no 2 (18 janvier 2023) : 193. http://dx.doi.org/10.3390/medicina59020193.

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Autoimmune pancreatitis is a rare form of chronic pancreatitis of presumed autoimmune etiology. Due to significant overlap in clinical and imaging characteristics, misdiagnosis as a pancreatic malignancy is common. As a result, a significant number of patients undergo a major pancreatic resection, associated with considerable morbidity, for a disease process that generally responds well to corticosteroid therapy. In the past ten years, important advances have been made in understanding the disease. Several diagnostic criteria have been developed to aid in diagnosis. Despite this, pancreatic resection may still be required in a subset of patients to reliably exclude pancreatic malignancy and establish a definite diagnosis of autoimmune pancreatitis. This article aimed to define the role of surgery in autoimmune pancreatitis, if any. For this purpose, published case series of patients with a diagnosis of autoimmune pancreatitis, based on the histopathological examination of surgical specimens, were reviewed and patients’ clinical, radiological and serological details were assessed. At the end, histopathologic examinations of patients who underwent pancreatic resection at our department in the last 10 years were retrospectively reviewed in order to identify patients with autoimmune pancreatitis and assess their clinical characteristics.
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Bojková, Martina, Petr Dítě, Jana Dvořáčková, Ivo Novotný, Katarina Floreánová, Bohuslav Kianička, Magdalena Uvírová et Arnošt Martínek. « Immunoglobulin G4, Autoimmune Pancreatitis and Pancreatic Cancer ». Digestive Diseases 33, no 1 (17 décembre 2014) : 86–90. http://dx.doi.org/10.1159/000368337.

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Background: Immunoglobulin G4 (IgG4)-related diseases are a group of diseases characterized by enlargement of the affected organs, elevation of serum IgG4, massive infiltration of affected organs with lymphocytes and plasma cells with IgG4 positivity and tissue fibrosis. Type I autoimmune pancreatitis is one form of IgG4-related disease. For IgG4-related diseases, various localizations are described for up to 10% of malignancies. The aim of our study was to examine IgG4 serum levels and pancreatic tissue with respect to the simultaneous presence of autoimmune pancreatitis in patients with pancreatic cancer. Methods: IgG4 serum levels were examined In 106 patients with histologically confirmed pancreatic cancer. The level of 135 mg/dl was considered as the normal value. Pancreatic tissue was histologically examined with respect to the presence of markers of autoimmune pancreatitis. Results: A higher IgG4 level than the cut-off value of 135 mg/dl was proven in 11 patients with pancreatic cancer. Of these 11 patients, 7 had levels twice the normal limit (65.6%). Autoimmune pancreatitis was diagnosed in these individuals. In the case of 1 patient, it was basically an unexpected finding; another patient was initially diagnosed with autoimmune pancreatitis. Repeated biopsy of the pancreas at the time of diagnosis did not confirm the presence of tumour structures, therefore steroid therapy was started. At a check-up 6 months after starting steroid therapy, the condition of the patient improved subjectively and IgG4 levels decreased. However, endosonographically, malignancy was suspected, which was subsequently confirmed histologically. This patient also demonstrated an IgG4 level twice the normal limit. Conclusion: IgG4-related diseases can be accompanied by the simultaneous occurrence of malignancies, which also applies to autoimmune pancreatitis. Chronic pancreatitis is considered a risk factor for pancreatic cancer. It cannot be reliably confirmed whether this also applies to autoimmune pancreatitis. In accordance with other works, however, it is evident that, despite the described high sensitivity and specificity for IgG4 elevation in the case of autoimmune pancreatitis, even levels twice the normal limit are demonstrable in some individuals with pancreatic cancer, without the presence of autoimmune pancreatitis. We believe that patients with IgG4-related disease, including autoimmune pancreatitis, must be systematically monitored with respect to the potential presence of malignancy.
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Raina, Amit, Alyssa M. Krasinskas, Julia B. Greer, Janette Lamb, Erin Fink, A. James Moser, Herbert J. Zeh III, Adam Slivka et David C. Whitcomb. « Serum Immunoglobulin G Fraction 4 Levels in Pancreatic Cancer : Elevations Not Associated With Autoimmune Pancreatitis ». Archives of Pathology & ; Laboratory Medicine 132, no 1 (1 janvier 2008) : 48–53. http://dx.doi.org/10.5858/2008-132-48-sigfli.

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Abstract Context.—Autoimmune pancreatitis is an uncommon, inflammatory disease of the pancreas that presents with clinical features, such as painless jaundice and a pancreatic mass, similar to those caused by pancreatic cancer. Patients with autoimmune pancreatitis frequently have elevated serum immunoglobulin G fraction 4 (IgG4) levels, and their pancreatic tissue may show IgG4-positive plasma cell infiltration. It is imperative to differentiate autoimmune pancreatitis from pancreatic cancer because autoimmune pancreatitis typically responds to corticosteroid treatment. A previous Japanese study reported that serum IgG4 greater than 135 mg/dL was 97% specific and 95% sensitive in predicting autoimmune pancreatitis. Objective.—To prospectively measure serum IgG4 levels in pancreatic cancer patients to ascertain whether increased levels might be present in this North American population. Design.—We collected blood samples and phenotypic information on 71 consecutive pancreatic cancer patients and 103 healthy controls who visited our clinics between October 2004 and April 2006. IgG4 levels were determined using a single radial immunodiffusion assay. A serum IgG4 level greater than 135 mg/dL was considered elevated. Results.—Five cancer patients had IgG4 elevation, with a mean serum IgG4 level of 160.8 mg/dL. None of our cancer patients with plasma IgG4 elevation demonstrated evidence of autoimmune pancreatitis. One control subject demonstrated elevated serum IgG4 unrelated to identified etiology. Conclusions.—As many as 7% of patients with pancreatic cancer have serum IgG4 levels above 135 mg/dL. In patients with pancreatic mass lesions and suspicion of cancer, an IgG4 level measuring between 135 and 200 mg/dL should be interpreted cautiously and not accepted as diagnostic of autoimmune pancreatitis without further evaluation.
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Papp, Kata, Eliane Angst, Stefan Seidel, Renata Flury-Frei et Franc Heinrich Hetzer. « The Diagnostic Challenges of Autoimmune Pancreatitis ». Case Reports in Gastroenterology 9, no 1 (12 février 2015) : 56–61. http://dx.doi.org/10.1159/000377623.

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Autoimmune pancreatitis is a rare but important differential diagnosis from pancreatic cancer. This autoimmune disease can mimic pancreatic cancer by its clinical symptoms, including weight loss and jaundice. Furthermore imaging findings may include a mass of the pancreas. Here we present the case of a 67-year-old male patient diagnosed with autoimmune pancreatitis but showing the well-known symptoms of pancreatic cancer. This emphasizes the difficulties of histological findings and the importance of the correct diagnostic process.
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Chandrasegaram, Manju D., Su C. Chiam, Nam Q. Nguyen, Andrew Ruszkiewicz, Adrian Chung, Eu L. Neo, John W. Chen, Christopher S. Worthley et Mark E. Brooke-Smith. « A Case of Pancreatic Cancer in the Setting of Autoimmune Pancreatitis with Nondiagnostic Serum Markers ». Case Reports in Surgery 2013 (2013) : 1–6. http://dx.doi.org/10.1155/2013/809023.

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Background. Autoimmune pancreatitis (AIP) often mimics pancreatic cancer. The diagnosis of both conditions is difficult preoperatively let alone when they coexist. Several reports have been published describing pancreatic cancer in the setting of AIP.Case Report. The case of a 53-year-old man who presented with abdominal pain, jaundice, and radiological features of autoimmune pancreatitis, with a “sausage-shaped” pancreas and bulky pancreatic head with portal vein impingement, is presented. He had a normal serum IgG4 and only mildly elevated Ca-19.9. Initial endoscopic ultrasound-(EUS-) guided fine-needle aspiration (FNA) of the pancreas revealed an inflammatory sclerosing process only. A repeat EUS guided biopsy following biliary decompression demonstrated both malignancy and features of autoimmune pancreatitis. At laparotomy, a uniformly hard, bulky pancreas was found with no sonographically definable mass. A total pancreatectomy with portal vein resection and reconstruction was performed. Histology revealed adenosquamous carcinoma of the pancreatic head and autoimmune pancreatitis and squamous metaplasia in the remaining pancreas.Conclusion. This case highlights the diagnostic and management difficulties in a patient with pancreatic cancer in the setting of serum IgG4-negative, Type 2 AIP.
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Smyk, Daniel S., Eirini I. Rigopoulou, Andreas L. Koutsoumpas, Stephen Kriese, Andrew K. Burroughs et Dimitrios P. Bogdanos. « Autoantibodies in Autoimmune Pancreatitis ». International Journal of Rheumatology 2012 (2012) : 1–8. http://dx.doi.org/10.1155/2012/940831.

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Autoimmune pancreatitis (AIP) was first used to describe cases of pancreatitis with narrowing of the pancreatic duct, enlargement of the pancreas, hyper-γ-globulinaemia, and antinuclear antibody (ANA) positivity serologically. The main differential diagnosis, is pancreatic cancer, which can be ruled out through radiological, serological, and histological investigations. The targets of ANA in patients with autoimmune pancreatitis do not appear to be similar to those found in other rheumatological diseases, as dsDNA, SS-A, and SS-B are not frequently recognized by AIP-related ANA. Other disease-specific autoantibodies, such as, antimitochondrial, antineutrophil cytoplasmic antibodies or diabetes-specific autoantibodies are virtually absent. Further studies have focused on the identification of pancreas-specific autoantigens and reported significant reactivity to lactoferrin, carbonic anhydrase, pancreas secretory trypsin inhibitor, amylase-alpha, heat-shock protein, and plasminogen-binding protein. This paper discusses the findings of these investigations and their relevance to the diagnosis, management, and pathogenesis of autoimmune pancreatitis.
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Cirocchi, Roberto, Alberto Santoro, Alessia Corsi, Paolo Ronca, Jacopo Desiderio, Francesco Barberini, Carlo Boselli et Giuseppe Noya. « Autoimmune pancreatitis : a case of difficult diagnosis ». Gastroenterology Review 1 (2015) : 51–53. http://dx.doi.org/10.5114/pg.2014.47500.

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9

Kozoriz, Michael G., Tracy M. Chandler, Roshni Patel, Charles V. Zwirewich et Alison C. Harris. « Pancreatic and Extrapancreatic Features in Autoimmune Pancreatitis ». Canadian Association of Radiologists Journal 66, no 3 (août 2015) : 252–58. http://dx.doi.org/10.1016/j.carj.2014.10.001.

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Autoimmune pancreatitis (AIP) accounts for approximately 5% of chronic pancreatitis cases and is an important consideration in the differential diagnosis of pancreatic pathologies. The underlying pathophysiology of AIP is thought to involve lymphocyte infiltration and associated sclerosis. Although AIP is a benign condition that is treatable with corticosteroids, it can have imaging and clinical findings indistinguishable from pancreatic cancer. As such, the radiologist plays an important management role in distinguishing AIP from more sinister conditions. In addition, there are several extrapancreatic imaging findings in the context of AIP that have been recently described. This pictorial review outlines both the pancreatic and extrapancreatic imaging features in AIP and the response to steroid therapy. Important imaging features that allow AIP to be differentiated from other pancreatic pathology, including adenocarcinoma, lymphoma, and acute pancreatitis will be discussed.
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Ectors, N., B. Maillet, R. Aerts, K. Geboes, A. Donner, F. Borchard, P. Lankisch et al. « Non-alcoholic duct destructive chronic pancreatitis ». Gut 41, no 2 (1 août 1997) : 263–68. http://dx.doi.org/10.1136/gut.41.2.263.

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Background—The pathology of non-alcoholic chronic pancreatitis has not yet been sufficiently studied.Aims—To identify the major changes of pancreatic tissue in patients surgically treated for non-alcoholic chronic pancreatitis.Patients—Pancreatectomy specimens from 12 patients with non-alcoholic chronic pancreatitis, including four patients with autoimmune or related diseases (Sjögren’s syndrome, primary sclerosing cholangitis, ulcerative colitis, and Crohn’s disease), were reviewed.Methods—Morphological changes were studied histologically and immunohistochemically (to type inflammatory cells) and compared with the pancreatic alterations found in 12 patients with alcoholic chronic pancreatitis.Results—In patients with non-alcoholic chronic pancreatitis, with or without associated autoimmune or related diseases, pancreatic inflammation particularly involved the ducts, commonly resulting in duct obstruction and occasionally duct destruction. None of these features was seen in alcoholic chronic pancreatitis which, however, showed pseudocysts and calcifications.Conclusion—The pancreatic changes in patients with non-alcoholic chronic pancreatitis clearly differ from those with alcoholic chronic pancreatitis. The term chronic duct destructive pancreatitis is suggested for this type of pancreatic disease.
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Kim, So Hyun, Seung-Ho Baek, Hye Yeong Kim, Su Jin Choi, Ji Hoon Kim, Se Hee Lee et Myung-Hwan Kim. « Adolescent Type 2 Autoimmune Pancreatitis ». Korean Journal of Medicine 95, no 2 (1 avril 2020) : 114–18. http://dx.doi.org/10.3904/kjm.2020.95.2.114.

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There are two forms of autoimmune pancreatitis (AIP). Type 1 is associated with immunoglobulin G4 (IgG4)-related systemic fibro- inflammatory disease, whereas type 2 AIP is localized to the pancreas and not associated with IgG4. The number of children presenting with type 2 AIP has recently increased. Here, we report a case of type 2 AIP in a 16-year-old adolescent who presented with clinical acute pancreatitis and associated pancreatic masses. He was diagnosed with type 2 AIP based on pancreatic biopsy results showing granulocytic epithelial lesions and supportive radiological imaging and steroid responsiveness.
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Cui, Xiaobing, Wen Xu, Yingchun Zhang, Fang Wang, Pei Guo et Wei Gong. « Autoimmune pancreatitis with pancreatic calculi and pseudocyst : a case report ». Journal of International Medical Research 49, no 5 (mai 2021) : 030006052110147. http://dx.doi.org/10.1177/03000605211014798.

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Autoimmune pancreatitis (AIP) is a unique form of pancreatitis often associated with infiltration of immunoglobulin G4-positive cells, a swollen pancreas, and diffuse narrowing of the pancreatic ducts. Unlike acute pancreatitis, AIP is rarely complicated with pseudocysts. Pancreatic calculi, a feature of ordinary chronic pancreatitis, are unusual during short-term follow-up in patients with AIP. We herein describe a 46-year-old man who initially presented with a submucosal tumor of the stomach. The patient was finally diagnosed with AIP accompanied by a pancreatic tail pseudocyst located in the gastric wall and pancreatic calculi by endoscopic ultrasonography-guided fine-needle aspiration. He underwent endoscopic retrograde cholangiopancreatography, pancreatic duct stent placement, and steroid treatment and achieved good clinical and laboratory responses. Although AIP is a common autoimmune disease that responds well to steroids, pseudocysts and pancreatic calculi are rare manifestations of AIP and should be given special attention, especially in patients with disease relapse.
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Robison, Lindsay, Cheri Canon, Shyam Varadarajulu, Mohamad Eloubeidi, Martin Heslin et Mel Wilcox. « Autoimmune Pancreatitis Mimicking Pancreatic Cancer ». American Journal of Gastroenterology 104 (octobre 2009) : S87. http://dx.doi.org/10.14309/00000434-200910003-00227.

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Dede, K., F. Salamon, A. Taller, D. Teknos et A. Bursics. « Autoimmune pancreatitis mimicking pancreatic tumor ». Journal of Surgical Case Reports 2012, no 11 (4 décembre 2012) : rjs012. http://dx.doi.org/10.1093/jscr/rjs012.

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15

Welsch, T., J. Kleeff, I. Esposito, MW Büchler et H. Friess. « Hepatobiliary and pancreatic : Autoimmune pancreatitis ». Journal of Gastroenterology and Hepatology 22, no 4 (avril 2007) : 592. http://dx.doi.org/10.1111/j.1440-1746.2007.04884.x.

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Robison, Lindsay S., Cheri L. Canon, Shyam Varadarajulu, Mohamad A. Eloubeidi, Selwyn Vickers et C. Mel Wilcox. « Autoimmune pancreatitis mimicking pancreatic cancer ». Journal of Hepato-Biliary-Pancreatic Sciences 18, no 2 (2 septembre 2010) : 162–69. http://dx.doi.org/10.1007/s00534-010-0321-1.

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Valero Liñán, Antonio Serafín, Juan Luis Rueda Martínez, José Antonio González Masiá, José Ignacio Miota de Llama et Pascual González Masegosa. « Autoimmune Pancreatitis or Pancreatic Cancer ? » Cirugía Española (English Edition) 94, no 7 (août 2016) : 415–17. http://dx.doi.org/10.1016/j.cireng.2016.08.003.

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Kim, Jin Hee, Jae Ho Byun, Myung-Hwan Kim, Sung Koo Lee, Song Cheol Kim, Hyoung Jung Kim, Seung Soo Lee, So Yeon Kim et Moon-Gyu Lee. « Pancreatic Duct in Autoimmune Pancreatitis ». Pancreas 46, no 7 (août 2017) : 921–26. http://dx.doi.org/10.1097/mpa.0000000000000853.

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Oliveira, Gustavo Mesquita De, Lia de Freitas Araújo Alves, Paloma Lucena Cabral, Ana Luiza Viana Pequeno, Clóvis Rêgo Coelho et Rodrigo Vieira Costa Lima. « Type 1 autoimmune pancreatitis ». Medicina (Ribeirao Preto Online) 53, no 1 (27 avril 2020) : 81–87. http://dx.doi.org/10.11606/issn.2176-7262.v53i1p81-87.

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Type 1 autoimmune pancreatitis is a cause of chronic pancreatitis related to the systemic disease known as IgG4-related Sclerosing Disease. Case report: We report the case of a 64-year-old male patient who presented recurrent epigastric pain radiating to the back, associated with jaundice, xerostomia, nausea, and vomiting, since 2014, diagnosed two years later with an unresectable pancreatic adenocarcinoma. The diagnosis was questioned after a few follow-up months without clinical deterioration when it was suggested the possibility of type 1 autoimmune pancreatitis in its pseudotumoral form. The patient was then treated with glucocorticoids, obtaining significant clinical improvement. After two years of follow-up, he returned asymptomatic with images suggestive of sclerosing cholangitis and a large liver abscess. Importance of the issue: The present case denotes the difficulty found in this diagnosis due to clinical and radiological resemblances with pancreatic adenocarcinoma. Besides that, it presents a seldom described disease complication, the liver abscess.
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Kogler, Hubert, Wolfgang Novak, Andreas Vécsei, Christina Zachbauer, Wolf-Dietrich Huber, Karoly Lakatos, Katharina Woeran, Judith Stift, Kaan Boztug et Leo Kager. « Occurrence of autoimmune pancreatitis after chronic immune thrombocytopenia in a Caucasian adolescent ». Clinical Journal of Gastroenterology 14, no 3 (20 mars 2021) : 918–22. http://dx.doi.org/10.1007/s12328-021-01383-w.

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AbstractAutoimmune pancreatitis is a rare, distinct and increasingly recognized form of chronic inflammatory pancreatic disease secondary to an underlying autoimmune mechanism. We report on a 14-year-old boy who developed autoimmune pancreatitis, while he was under treatment with eltrombopag for chronic immune thrombocytopenia. Therapy with corticosteroids resulted in complete remission of both. This is the first report on the co-occurrence of autoimmune pancreatitis and chronic immune thrombocytopenia in childhood, and clinicians should be aware of this rare association, because early diagnosis and therapy of autoimmune pancreatitis may prevent severe complications.
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Akshintala, V. S., et V. K. Singh. « Management of autoimmune pancreatitis ». Herald of Pancreatic Club 48, no 3 (31 juillet 2020) : 13–17. http://dx.doi.org/10.33149/vkp.2020.03.02.

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The article contains modern data on such a chronic pancreatic disease as autoimmune pancreatitis (AIP). Statistical data on the prevalence and incidence of AIP are presented, the current international classification of this pathology is considered, the main features of type 1 AIP (lymphoplasmacytic sclerosing pancreatitis, LPSP) and type 2 AIP (idiopathic duct centric pancreatitis, IDCP) are put forward. The clinical manifestation of these types is different: obstructive jaundice develops more often in patients with LPSP, while patients with IDCP mostly have acute pancreatitis. The presence and variety of extrapancreatic manifestations of the disease with extremely frequent concomitant development of ulcerative colitis is emphasized. The features of serological diagnosis of AIP and the role of IgG4 level in determining the type of disease are considered. The proper techniques of AIP instrumental diagnostics are listed, the typical changes detected during computed tomography and the distinctive histological characteristics of LPSP and IDCP are considered. The feasibility of a differential diagnosis between AIP and pancreatic cancer is indicated by analyzing the results of serological, imaging, and histological studies. The algorithm of management of AIP patients depending on the type of disease is described, as well as the tactics of prescribing corticosteroids, immunomodulators upon LPSP and IDCP. Immunomodulators of choice (mycophenolate mofetil, azathioprine) are indicated, and rituximab administration features are considered. Possible signs of AI recurrence are listed (IgG4-sclerosing cholangitis, high IgE level).
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Bor, Renáta, Klaudia Farkas, Anita Bálint, Tibor Wittmann, Ferenc Nagy, László Tiszlavicz, Tamás Molnár et Zoltán Szepes. « Autoimmune pancreatitis in a patient with ulcerative colitis. Pancreatic tumor as a deceptive appearance ». Orvosi Hetilap 155, no 25 (juin 2014) : 1000–1004. http://dx.doi.org/10.1556/oh.2014.29936.

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Pancreatic endocrine and/or exocrine functional disorders can be commonly detected in patients with inflammatory bowel diseases. Autoimmune pancreatitis is a rare disease and its co-existence with inflammatory bowel disease has been rarely reported. The diagnosis of autoimmune pancreatitis is difficult due to variable nonspecific symptoms, and the high rate of asymptomatic cases. The conventional imaging scans (ultrasonography, computed tomography, retrograde cholangiography) are usually not sensitive enough and they are frequently not able to differentiate between inflammatory and malignant tumorous diseases of the pancreas. The authors present the case history of a patient who developed both ulcerative colitis and autoimmune pancreatitis. The morphological changes of the pancreas detected by ultrasonography suggested the presence of pancreatic cancer, and this diagnosis was supported by the elevated level of serum CA19-9. Computed tomography failed to identify abnormalities in the pancreas and, finally, endoscopic ultrasound combined with fine needle aspiration cytology confirmed the diagnosis of autoimmune pancreatitis. Orv. Hetil., 2014, 155(25), 1000–1004.
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Zamboni, Giuseppe, Paola Capelli, Aldo Scarpa, Giuseppe Bogina, Anna Pesci, Eleonora Brunello et Günter Klöppel. « Nonneoplastic Mimickers of Pancreatic Neoplasms ». Archives of Pathology & ; Laboratory Medicine 133, no 3 (1 mars 2009) : 439–53. http://dx.doi.org/10.5858/133.3.439.

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Abstract Context.—A variety of nonneoplastic conditions may form pancreatic masses that mimic carcinoma. Approximately 5% to 10% of pancreatectomies performed with the clinical diagnosis of pancreatic cancer prove on microscopic evaluation to be pseudotumors. Objectives.—To illustrate the clinical and pathologic characteristics of the 2 most frequent pseudotumoral inflammatory conditions, autoimmune pancreatitis and paraduodenal pancreatitis, and describe the criteria that may be useful in the differential diagnosis versus pancreatic carcinoma. Data Sources.—Recent literature and the authors' experience with the clinical and pathologic characteristics of autoimmune pancreatitis and paraduodenal pancreatitis. Conclusions.—The knowledge of the clinical, radiologic, and pathologic findings in both autoimmune pancreatitis and paraduodenal pancreatitis is crucial in making the correct preoperative diagnosis. Autoimmune pancreatitis, which occurs in isolated or syndromic forms, is characterized by a distinctive fibroinflammatory process that can either be limited to the pancreas or extend to the biliary tree. Its correct preoperative identification on biopsy material with ancillary immunohistochemical detection of dense immunoglobulin G4-positive plasma cell infiltration is possible and crucial to prevent major surgery and to treat these patients with steroid therapy. Paraduodenal pancreatitis is a special form of chronic pancreatitis that affects young males with a history of alcohol abuse and predominantly involves the duodenal wall in the region of the minor papilla. Pathogenetically, the anatomical and/or functional obstruction of the papilla minor, resulting from an incomplete involution of the intraduodenal dorsal pancreas, associated with alcohol abuse represents the key factor. Endoscopic drainage of the papilla minor, with decompression of the intraduodenal and dorsal pancreas, might be considered in these patients.
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Koller, Tomáš, Petra Vrbová, Viliam Gál et Iveta Mečiarová. « A rare cause of painless obstructive jaundice in the elderly – a case series ». Gastroenterologie a hepatologie 76, no 5 (31 octobre 2022) : 392–98. http://dx.doi.org/10.48095/ccgh2022392.

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Summary: A series of two case reports discusses the differential diagnosis of painless jaundice in the elderly and points to autoimmune pancreatitis as one of its rarer causes. In search for the cause, the first step is to rule out the malignant origin of the obstruction using the clinical picture, imaging examinations, and EUS-guided biopsy. An imaging examination can initially point to the possibility of autoimmune pancreatitis, but in the case of focal pancreatic involvement the distinction from cancer is unreliable. Elevated concentration of IgG4 antibodies can further increase the probability of IgG4-associated pancreatitis. Histological examination of the pancreas will help reveal typical features of autoimmune pancreatitis such as lymphoplasmacytic infiltrate, storiform fibrosis, obliterating phlebitis and increased number of IgG4 positive plasma cells. Once the diagnosis is probable, it is advisable to start a treatment with steroids. A quick decrease in cholestatic markers and bilirubin is typical. Patients with autoimmune pancreatitis require long-term follow-up, to adjust the treatment in case of relapses, the risk of developing exocrine or endocrine insufficiency, and in case of IgG4 associated disease due to the risk of other organ systems involvement. The risk of pancreatic cancer is still a matter of discussion. Key words: autoimmune pancreatitis – IgG4 – obstructive jaundice – case report
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Gubergrits, N. B., N. V. Byelyayeva, A. Ye Klochkov, G. M. Lukashevich, P. G. Fomenko et E. V. Berezhnaya. « Evidence-based pancreatology 2018 (review of research results on diseases and exocrine pancreatic insufficiency) ». Herald of Pancreatic Club 43, no 2 (3 mai 2019) : 4–14. http://dx.doi.org/10.33149/vkp.2019.02.01.

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The article presents a detailed review of the research results in the field of pancreatology published in 2018. Certain parts of the review are devoted to the pathogenesis, diagnostics, course of pancreatitis, its treatment, as well as autoimmune, hereditary pancreatitis, pancreatic pathology in children, as well as treatment. In studying the pathogenesis of pancreatitis, attention is paid to genetic markers of pancreatitis along with a role of bacterial overgrowth syndrome in the small intestine, both in terms of worsening of the course of pancreatitis and the lack of effectiveness of enzyme replacement therapy. The study of the role of alcohol abuse and smoking in the pathogenesis of pancreatic pathology is still in progress. Diagnostics is going on. Endosonography remains the most informative method. A number of studies have been devoted to the studying of exocrine and endocrine pancreatic insufficiency both upon pancreatitis, pancreatic tumors, and in functional dyspepsia and HIV infection. Autoimmune pancreatitis is increasingly being diagnosed, a number of studies are devoted to its diagnostics and treatment. Pancreatic diseases in children develop mainly on the background of genetic predisposition, while functional pancreatic insufficiency occurs in adult patients. The study of the peculiarities of the effect of enzyme replacement therapy continues. The immediate and remote results of the surgical treatment of pancreatic pathology are assessed.
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Anderloni, Andrea, Chiara Genco, Marco Ballarè, Stefania Carmagnola, Serena Battista et Alessandro Repici. « A Case of Primary Pancreatic non-Hodgkin B-cell Lymphoma Mimicking Autoimmune Pancreatitis ». Journal of Gastrointestinal and Liver Diseases 24, no 2 (1 juin 2015) : 245–48. http://dx.doi.org/10.15403/jgld.2014.1121.242.hdk.

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Non Hodgkin lymphoma frequently involves the gastrointestinal tract, in particular the stomach and the small bowel. Rarely, it can also be a cause of pancreatic masses. Clinical presentation is often non-specific and may overlap with other pancreatic conditions such as carcinoma, neuroendocrine tumours and autoimmune pancreatitis. We report a case of primary pancreatic lymphoma in a young woman with jaundice, fever and abdominal pain mimicking autoimmune pancreatitis. Clinical evaluation included the abdominal Computed Tomography scan, Magnetic Resonance Imaging and an upper gastrointestinal endoscopy that revealed a large duodenal mass. Endoscopic biopsies were performed and eventually histological examination was coherent with a diagnosis of primary pancreatic lymphoma.
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Dubravcsik, Zsolt, Gyula Farkas, Péter Hegyi, István Hritz, Dezső Kelemen, Natália Lásztity, Zita Morvay et al. « Autoimmune pancreatitis.Evidence based management guidelines of the Hungarian Pancreatic Study Group ». Orvosi Hetilap 156, no 8 (février 2015) : 292–307. http://dx.doi.org/10.1556/oh.2015.30061.

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Autoimmune pancreatitis is a rare disease which can even mimic pancreatic tumor, however, unlike the latter, it requires not surgical but conservative management. Correct diagnosis and differential diagnosis of autoimmune pancreatitis and treatment of these patients requires up-to-date and evidence based management guidelines. The Hungarian Pancreatic Study Group proposed to prepare an evidence based guideline based on the available international guidelines and evidences. The preparatory and consultation task force appointed by the Hungarian Pancreatic Study Group translated and complemented and/or modified the international guidelines if it was necessary. 29 relevant clinical questions in 4 topics were defined (Basics; Diagnosis; Differential diagnostics; Therapy). Evidence was classified according to the UpToDate®grading system. The draft of the guidelines was presented and discussed at the consensus meeting on September 12, 2014. All clinial questions were accepted with almost total (more than 95%) agreement. The present guideline is the first evidence based autoimmune pancreatitis guideline in Hungary. The guideline may provide very important and helpful data for tuition of autoimmune pancreatitis, for everyday practice and for establishing proper finance. Therefore, the authors believe that these guidelines will widely become a basic reference in Hungary. Orv. Hetil., 2015, 156(8), 292–307.
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Gaidar, Y. A., N. Y. Oshmyanska et A. P. Halenko. « Histostructure of pancreas in patients with autoimmune pancreatitis type I and II : connection with the level of IgG4-positive plasma cells ». Bulletin of the Club of Pancreatologists 35, no 1 (6 mars 2017) : 28–31. http://dx.doi.org/10.33149/vkp.2017.01.05.

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Differential diagnosis of autoimmune pancreatitis apart from everything else is based on specifics of immunoglobulin G4 involvement into the pathogenesis. Aim is to analyze two forms of autoimmune pancreatitis and their relation to the level of IgG4-positive plasma cells. Methods and results. The present study was conducted on 54 patients with chronic pancreatitis, from which 15 cases with autoimmune pancreatitis were selected by using morphological and immunohistochemical methods. Conclusion. It has been established that for autoimmune pancreatitis type I dense lymphocytic periductal infiltrate, multilevel fibrosis, obliterating venulitis and high IgG4-positive plasma cells in the pancreas (>30 per high power field) were typical. In the cases of autoimmune pancreatitis type II, besides the specific histopathological signs of AIP, significantly epithelial damage of pancreatic ducts by leukocytes, low levels of IgG4-PPC in the pancreas and focal lesions on stages I–III of disease (80%) were observed.
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Akhmedov, V. A., et O. V. Gaus. « Pancreatic diseases and inflammatory bowel diseases : a random or regular combination ? » Terapevticheskii arkhiv 92, no 1 (15 janvier 2020) : 76–81. http://dx.doi.org/10.26442/00403660.2020.01.000463.

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Pathology of the pancreas in inflammatory bowel disease (IBD) is more common than in the general population and includes a wide range of manifestations from asymptomatic to severe disorders. Acute pancreatitis, chronic pancreatitis, autoimmune pancreatitis, exocrine pancreatic insufficiency, increased pancreatic enzymes and structural duct anomalies are often associated with IBD. They can be either a manifestation of IBD itself or develop independently.
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Fousekis, F. S., V. I. Theopistos, K. H. Katsanos et D. K. Christodouloua. « Pancreatic involvement in inflammatory bowel disease : a review ». Herald of Pancreatic Club 44, no 3 (16 juillet 2019) : 23–32. http://dx.doi.org/10.33149/vkp.2019.03.02.

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Inflammatory bowel disease (IBD) is a multisystemic disease, and pancreatic manifestations of IBD are not uncommon. The incidence of several pancreatic diseases in Crohn’s disease and ulcerative colitis is more frequent compared to the general population. Pancreatic manifestations in IBD include a wide heterogenic group of disorders and abnormalities of the pancreas and range from mild self-limited diseases to severe disorders. Acute pancreatitis, chronic pancreatitis, autoimmune pancreatitis, pancreatic autoantibodies, exocrine pancreatic insufficiency and asymptomatic imaging and laboratory abnormalities are included in related-IBD pancreatic manifestations. Involvement of the pancreas in IBD may be the result of IBD itself or of medications used.
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Khanna K B, Jaydeesh, Steven Joseph Mesenas, Tracy Jiezhen Loh et Yung Ka Chin. « Autoimmune pancreatitis masquerading as pancreatic cancer ». VideoGIE 6, no 12 (décembre 2021) : 546–48. http://dx.doi.org/10.1016/j.vgie.2021.09.001.

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Khanna K B, Jaydeesh, Steven Joseph Mesenas, Tracy Jiezhen Loh et Yung Ka Chin. « Autoimmune pancreatitis masquerading as pancreatic cancer ». VideoGIE 6, no 12 (décembre 2021) : 546–48. http://dx.doi.org/10.1016/j.vgie.2021.09.001.

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Law, Ryan, XiuLi Liu, Matthew Walsh, Lisa Yerian, Shetal Shah et Tyler Stevens. « Pancreatic Resections of Autoimmune Pancreatitis (AIP) ». Gastroenterology 140, no 5 (mai 2011) : S—546. http://dx.doi.org/10.1016/s0016-5085(11)62263-4.

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Sugumar, Aravind, Naoki Takahashi et Suresh T. Chari. « Distinguishing Pancreatic Cancer from Autoimmune Pancreatitis ». Current Gastroenterology Reports 12, no 2 (12 mars 2010) : 91–97. http://dx.doi.org/10.1007/s11894-010-0098-z.

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Miyoshi, Hideaki, Masataka Kano, Sanshiro Kobayashi, Takashi Ito, Masataka Masuda, Toshiyuki Mitsuyama, Shinji Nakayama et al. « Diffuse Pancreatic Cancer Mimicking Autoimmune Pancreatitis ». Internal Medicine 58, no 17 (1 septembre 2019) : 2523–27. http://dx.doi.org/10.2169/internalmedicine.2689-19.

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Park, Jinoh, Dongwook Oh, Minseon Cheong, Jiyoon Kim, Jin Sun Oh, Tae Jun Song, Seung-Mo Hong et Myung-Hwan Kim. « Pancreatic Lymphoma Masquerading as Autoimmune Pancreatitis ». Korean Journal of Pancreas and Biliary Tract 20, no 4 (30 octobre 2015) : 204–8. http://dx.doi.org/10.15279/kpba.2015.20.4.204.

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Shakov, Rada, Kiran Jagarlamudi, Hossam Elfarra et Walid Baddoura. « Autoimmune Pancreatitis Masquerading as Pancreatic Cancer ». American Journal of Gastroenterology 102 (septembre 2007) : S327. http://dx.doi.org/10.14309/00000434-200709002-00571.

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Mohammed, Asim A., Nirali Parikh et Hareth M. Raddawi. « Autoimmune Pancreatitis (AIP) Mimicking Pancreatic Cancer ». American Journal of Gastroenterology 101 (septembre 2006) : S355—S356. http://dx.doi.org/10.14309/00000434-200609001-00889.

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Karimi, Shawhin, et Parth Bharill. « Autoimmune Pancreatitis : A Case of Atypical Radiographic Findings ». Case Reports in Gastroenterology 10, no 3 (18 octobre 2016) : 581–88. http://dx.doi.org/10.1159/000448988.

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Autoimmune pancreatitis (AIP) is a rare pancreatic disorder that can present as a manifestation of a broader systemic inflammatory disease known as immunoglobulin G4-related systemic disease (IGG4-RSD). AIP is divided into two subtypes based on clinical, radiological, and histological findings. The disease can be mistaken for pancreatic cancer because of overlapping clinical and radiological findings, but early recognition can help avoid unnecessary surgery. We present a case of a 65-year-old female with suspected acute gallstone pancreatitis found to have AIP based on serology, radiological findings, and response to steroids.
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Gouveia, Carolina Isabel, Laura Oliveira, António P. Campos et José Cabral. « Autoimmune pancreatitis with associated ulcerative colitis in a teenager ». BMJ Case Reports 11, no 1 (décembre 2018) : e227888. http://dx.doi.org/10.1136/bcr-2018-227888.

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Autoimmune pancreatitis (AIP) is a rare entity that is extremely uncommon in children. Its diagnosis is also a clinical challenge. This form of chronic pancreatitis often presents itself with obstructive jaundice and/or a pancreatic mass and it is sometimes misdiagnosed as pancreatic cancer. We describe the case of a 13-year-old boy with obstructive jaundice and a 4 cm mass in the head of the pancreas that was diagnosed as AIP with associated ulcerative colitis.
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Vitali, Francesco, Deike Strobel, Luca Frulloni, Marc Heinrich, Lukas Pfeifer, Ruediger Stephan Goertz, Gheorghe Hundorfean et al. « The importance of pancreatic inflammation in endosonographic diagnostics of solid pancreatic masses ». Medical Ultrasonography 20, no 4 (8 décembre 2018) : 427. http://dx.doi.org/10.11152/mu-1641.

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Aims: Endosonography (EUS) is one of the main diagnostic tools for the differential diagnosis of pancreatic masses. The aim of our study was to describe the value of this technique in the work-up of solid pancreatic lesions, considering the influence of the morphological evidence of pancreatic inflammation in the diagnostic process.Material and methods: Retrospective analysis of prospectively collected data in our tertiary University center. From March 2007 to October 2015, 218 patients underwent EUS for a suspected solid pancreatic neoplasm (based on previous cross-sectional imaging results, idiopatic acute pancreatitis, weight loss, pancreatic hyperenzymemia, painless jaundice or elevated Ca 19-9 values).Results: Malignant lesions were diagnosed in 98 (45%) patients. Sensitivity of EUS for malignancy was 91% and specificity 89.2%. Signs of pancreatic inflammation in the surrounding pancreatic parenchyma around the focal lesion were present in 97 patients (44.4%)(more often in men, smokers and drinkers, and the most common etiology was focal chronic pancreatitis) and in these patients the sensitivity and sensibility dropped to 44% and 87.1%, respectively. In patients without signs of pancreatic inflammation, the pancreatic focal lesions were adenocarcinoma, neuroendocrine tumor, ventral/dorsal split, non-pancreatic pathology, pancreatic lipomatosis and autoimmune pancreatitis.Conclusion: Pancreatic inflammation (either focal or involving the whole gland) lowers the diagnostic sensibility of EUS in the work- up of pancreatic masses suspected for cancer, requiring further invasive diagnostic methods. Focal autoimmune pancreatitis and paraduodenal pancreatitis are still confused with pancreatic cancer, even in the absence of pancreatic inflammation.
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Hsu, Wen-Ling, Shu-Min Chang, Pei-Yin Wu et Chin-Chuan Chang. « Localized autoimmune pancreatitis mimicking pancreatic cancer : Case report and literature review ». Journal of International Medical Research 46, no 4 (14 janvier 2018) : 1657–65. http://dx.doi.org/10.1177/0300060517742303.

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Autoimmune pancreatitis (AP) is a rare autoimmune pancreatic manifestation of systemic immunoglobulin G4 (IgG4)-related sclerosing disease. Distinguishing between AP and pancreatic cancer is crucial because the clinical courses, treatments, and prognoses of these two disease entities are quite different. We herein report a case involving a 52-year-old man with subacute epigastralgia who visited our hospital for evaluation of a suspicious pancreatic mass found during esophagogastroduodenoscopy. Enhanced computed tomography (CT) revealed an enlarged lesion in the pancreatic head with encasement of hepatic vessels. The lesion also exhibited increased 18F-fluorodeoxyglucose accumulation on positron emission tomography/CT imaging, which was highly suggestive of pancreatic cancer. After open biopsy, morphologic examination showed an inflammatory infiltrate in the pancreas, which was compatible with chronic sclerotic pancreatitis. Further laboratory tests revealed an elevated serum IgG4 level, and the diagnosis of sclerotic pancreatitis was then confirmed. After corticosteroid treatment, the pancreatic lesion showed shrinkage on follow-up CT, and the serum IgG4 titer decreased to the normal range. This case suggests that clinicians should be familiar with the clinical presentations and diagnostic criteria of AP versus pancreatic cancer. An awareness of the differences between these diseases may avoid misdiagnosis and unnecessary surgical intervention.
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Brcerevic, Irina, Radoje Doder, Nenad Perisic, Stanko Petrovic, Jasna Jovic, Dejan Hristovic, Zoran Djordjevic et Olga Tasic-Radic. « Autoimmune pancreatitis type 1 and type 2 : A report of two cases ». Vojnosanitetski pregled 74, no 4 (2017) : 361–66. http://dx.doi.org/10.2298/vsp151007192b.

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Introduction. Autoimmune pancreatitis is a disease associated with autoimmune mechanisms, clinically manifested mostly as obstructive icterus with or with no entire or partial enlargement of the pancreas, histological lymphoplas-mocytic infiltration, fibrosis or granulocytic epithelial lesions with a favourable therapeutic response to the application of corticosteroids. Type 1 autoimmune pancreatitis is a systemic disease befalling the group of IgG4-related diseases in contrast to type 2 which is specific for pancreas disease. Case report. We presented two cases. The first one was a 64-year-old male patient with autoimmune pancreatitis complaining of abdominal pain, weight loss, weakness and exhaustion. Clinical examination showed a rare IgG4 autoimmune pancreatitis. The second one was a 37-year-old male patient complaining of abdominal pain with diarrhea. The diagnosis made revealed the presence of type 2 autoimmune pancreatitis. Following the diagnosis, immunosuppressive therapy was administered to both patients leading to the improvement of their general condition. Conclusion. Autoimmune pancreatitis is a rare disease, sometimes not easy to differ from pancreatic tumor or bile duct tumor with poor prognosis. Thus, early recognition of the disease is very important, since adequate treatment significantly increases the course and the outcomes of the disease.
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Yanagisawa, Kiyoshi, Shuta Tomida, Keitaro Matsuo, Chinatsu Arima, Miyoko Kusumegi, Yukihiro Yokoyama, Shigeru B. H. Ko et al. « Seven-Signal Proteomic Signature for Detection of Operable Pancreatic Ductal Adenocarcinoma and Their Discrimination from Autoimmune Pancreatitis ». International Journal of Proteomics 2012 (14 mai 2012) : 1–11. http://dx.doi.org/10.1155/2012/510397.

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There is urgent need for biomarkers that provide early detection of pancreatic ductal adenocarcinoma (PDAC) as well as discrimination of autoimmune pancreatitis, as current clinical approaches are not suitably accurate for precise diagnosis. We used mass spectrometry to analyze protein profiles of more than 300 plasma specimens obtained from PDAC, noncancerous pancreatic diseases including autoimmune pancreatitis patients and healthy subjects. We obtained 1063 proteomic signals from 160 plasma samples in the training cohort. A proteomic signature consisting of 7 mass spectrometry signals was used for construction of a proteomic model for detection of PDAC patients. Using the test cohort, we confirmed that this proteomic model had discrimination power equal to that observed with the training cohort. The overall sensitivity and specificity for detection of cancer patients were 82.6% and 90.9%, respectively. Notably, 62.5% of the stage I and II cases were detected by our proteomic model. We also found that 100% of autoimmune pancreatitis patients were correctly assigned as noncancerous individuals. In the present paper, we developed a proteomic model that was shown able to detect early-stage PDAC patients. In addition, our model appeared capable of discriminating patients with autoimmune pancreatitis from those with PDAC.
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Kamisawa, Terumi, Hitoshi Nakajima, Naoto Egawa, Kouji Tsuruta et Atsutake Okamoto. « Autoimmune Dorsal Pancreatitis : Involvement of the Pancreatic and Bile Ducts in Autoimmune Pancreatitis ». Gastrointestinal Endoscopy 65, no 5 (avril 2007) : AB239. http://dx.doi.org/10.1016/j.gie.2007.03.531.

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Belabess, S., M. Salihoun, M. Acherki et N. Kabbaj. « Autoimmune Pancreatitis Mimicking Pancreatic Cancer : Case Report ». Saudi Journal of Medical and Pharmaceutical Sciences 8, no 10 (29 octobre 2022) : 611–15. http://dx.doi.org/10.36348/sjmps.2022.v08i10.015.

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The positive diagnosis of autoimmune pancreatitis (AIP) can be challenging and poses a problem of differential diagnosis with pancreatic cancer. It’s most sensitive and specific biological marker is the serum IgG4 level. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) plays a key role in the positive and differential diagnosis. Treatment is based on corticosteroid therapy. We report the case of a 43-year-old female patient admitted for cholestatic jaundice with a cephalic pancreatic mass on imaging simulating pancreatic cancer.
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Janssens, Laurens, Naoki Takahashi et Shounak Majumder. « Pancreatic Atrophy in Nivolumab-Associated Pancreatitis Mimics Autoimmune Pancreatitis ». Pancreas 50, no 3 (mars 2021) : e28-e29. http://dx.doi.org/10.1097/mpa.0000000000001756.

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Kunovsky, L., P. Dite, J. Dolina, Z. Kala, M. Blaho, J. Dvorackova, M. Uvirova et al. « Pancreatic solid focal lesions : autoimmune pancreatitis or pancreatic cancer ? » Pancreatology 20 (novembre 2020) : S153. http://dx.doi.org/10.1016/j.pan.2020.07.292.

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Hesse, Felix, Rickmer Braren, Roland M. Schmid et Veit Phillip. « Autoimmune Pancreatitis Type 1 Associated with a Pancreatic Pseudocyst ». Case Reports in Gastroenterology 13, no 1 (9 avril 2019) : 195–99. http://dx.doi.org/10.1159/000499444.

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Pancreatic cystic lesions comprise diverse entities with different histopathological characteristics. Differential diagnosis is often challenging. Autoimmune pancreatitis (AIP) is usually not considered an underlying pathology in the differential diagnosis of peri-/pancreatic pseudo-/cystic lesions. We report the case of a 73-year-old male with diffuse pancreatic enlargement and an adjacent cystic lesion (60 × 80 mm) on computed tomography scan. Based on these imaging findings and an elevated serum IgG4 concentration, AIP complicated by a pancreatic pseudocyst was diagnosed, and treatment with glucocorticoids was started. Regular follow-ups showed a good response to treatment with regression of the pancreatic pseudocyst and remittent pancreatic swelling.
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Shah, Diva S., Bharat Prajapati, Kintan Sanghavi, Shubhda Kanhere, Jagdish Kothari et Jignesh Dubal. « Mass Mimicking Autoimmune Pancreatitis—A Report of Two Cases and Review of Literature ». Journal of Gastrointestinal and Abdominal Radiology 04, no 02 (3 mars 2021) : 154–60. http://dx.doi.org/10.1055/s-0041-1722813.

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AbstractAutoimmune pancreatitis (AIP) consists of two clinically histologically distinct forms (type I and II) of chronic pancreatitis that are histologically different. These forms of AIP classically respond to oral steroids. The focal form of AIP resembles pancreatic carcinoma both clinically and radiologically and it is of utmost importance to make an early correct diagnosis between these two diseases in order to identify the optimal therapeutic strategy and to avoid unnecessary laparotomy or pancreatic resection in AIP patients. Here we report focal forms of type I and II AIP with clinical and imaging features closely mimicking pancreatic carcinoma.
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