自身免疫性胰腺炎的诊断

自身免疫性胰腺炎（AIP）是一类特殊的慢性胰腺炎，其临床上依据组织学分为Ⅰ型和Ⅱ型。我国以Ⅰ型为主，是 IgG4相关性疾病的一部分，常表现为梗阻性黄疸或胰腺实质的肿块。组织学上表现为病变组织大量淋巴浆细胞的浸润及慢性纤维化。虽然国际胰腺病协会围绕其影像学、血清学、组织学及激素治疗的反应制定了诊断标准，但 AIP的临床表现较为隐匿和多样，其诊断仍然具有挑战性，特别是表现为胰腺肿块的患者，需要时刻警惕胰腺癌的风险。本文从影像学、组织学角度对文献进行了概述，重点是这种复杂疾病的诊断及误诊的风险，以期提高本病的鉴别诊断水平。

Diagnosis of autoimmune pancreatitis

Autoimmune pancreatitis (AIP) is a distinct form of chronic pancreatitis, which is clinically divided into twotypes (type Ⅰ and type Ⅱ) according to histology. Type Ⅰ is the main disease in China, which is a part of the IgG4-related disease characterized clinically by obstructive jaundice or a pancreatic mass, histologically by numerous lymphoplasmacytic infiltrate and chronic fibrosis. Although the International Association of Pancreatology (IAP) has developed diagnostic criteria for its imaging, serology, histology and hormone therapy responses, the clinical features of autoimmune pancreatitis are occult and varied, the diagnosis of autoimmune pancreatitis remains challenging, particularly in patients with pancreatic masses, which need to be alert to the risk of the pancreatic cancer. This review is to summarize the literature from the perspective of image and histology, focusing on the diagnosis and risk of misdiagnosis of this complex disease, in order toimprove the diagnosis of autoimmune pancreatitis.