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The Clinical and Radiological Characteristics of Focal Mass-Forming Autoimmune Pancreatitis

2009; Lippincott Williams & Wilkins; Volume: 38; Issue: 4 Linguagem: Inglês

10.1097/mpa.0b013e31818d92c0

1536-4828

Woo Ik Chang, Beom Jin Kim, Jong Kyun Lee, Pung Kang, Kwang Hyuck Lee, Kyu Taek Lee, Poong‐Lyul Rhee, Kee‐Taek Jang, Seong‐Ho Choi, Dong Wook Choi, Dong Il Choi, Jae Hoon Lim,

Gastrointestinal disorders and treatments

We investigated the clinical and radiological features of focal mass-forming autoimmune pancreatitis (FMF AIP) to help physicians avoid performing unnecessary surgery because of an improper diagnosis.We evaluated 23 patients with chronic inflammatory pancreatic masses and who underwent pancreatectomy for presumed pancreatic cancer from April 1995 to December 2005. These patients were distinguished into 8 FMF AIP patients and 15 ordinary chronic pancreatitis patients through a histological review, along with considering the immunoglobulin G4 staining. Twenty-six randomly selected pancreatic cancer patients were also evaluated as a control group.On the portal venous phase of computed tomography, 6 (85.7%) of 7 FMF AIP patients showed homogeneous enhancement, whereas only 3 chronic pancreatitis patients (25%) and none of the pancreatic cancer patients showed homogeneous enhancement (P < 0.001). None of the FMF AIP patients showed upstream main pancreatic duct dilatation greater than 5 mm or proximal pancreatic atrophy.For patients with a pancreatic mass, if their radiological images show homogeneous enhancement on the portal venous phase, the absence of significant upstream main pancreatic duct dilatation greater than 5 mm, and the absence of proximal pancreatic atrophy, then conducting further evaluations should be considered to avoid performing unnecessary surgery.