Type 1 Autoimmune Pancreatitis Extending along the Main Pancreatic Duct: IgG4-related Pancreatic Periductitis |
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| Authors: | Junya Sato Hiroyuki Matsubayashi Hirotoshi Ishiwatari Tatsunori Satoh Junichi Kaneko Kazuma Ishikawa Masao Yoshida Kohei Takizawa Yohei Yabuuchi Yoshihiro Kishida Kenichiro Imai Kinichi Hotta Katsuhiko Uesaka Keiko Sasaki Hiroyuki Ono |
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| Affiliation: | 1.Division of Endoscopy, Shizuoka Cancer Center, Japan; 2.Division of Genetic Medicine Promotion, Shizuoka Cancer Center, Japan; 3.Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Japan; 4.Division of Pathology, Shizuoka Cancer Center, Japan |
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| Abstract: | We herein report a unique form of autoimmune pancreatitis (AIP) spreading along the main pancreatic duct (MPD). A 70-year-old man was referred for a small lesion at the pancreatic neck, accompanying an adjacent cyst and dilated upstream MPD. Four years earlier, health checkup images had shown a pancreatic cyst but no mass lesion. Endoscopic ultrasonography showed a contrast-enhanced, tumorous lesion, mainly occupying the MPD. With a preoperative diagnosis of ductal neoplasms mainly spreading in the MPD, Whipple''s resection was performed. The resected specimens showed MPD periductitis with IgG4-related pathology, indicating type 1 AIP. Clinicians should practice caution concerning the various AIP forms. |
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| Keywords: | autoimmune pancreatitis IgG4 periductitis intraductal neoplasms diagnosis |
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