title: Incidence of the focal type of autoimmune pancreatitis in chronic pancreatitis suspected to be pancreatic carcinoma: experience of a single tertiary cancer center.
abstract: OBJECTIVE
  With an increase in autoimmune pancreatitis (AIP) being reported, the focal type of AIP, which shows localized narrowing of the main pancreatic duct and focal swelling of the pancreas, has recently been recognized. Therefore, cases of focal-type AIP subjected to surgical intervention for presumptive malignancy might previously have been diagnosed as mass-forming chronic pancreatitis. The aim of this study was to elucidate the incidence of focal-type AIP in resected chronic pancreatitis at a single tertiary cancer center. The clinical and radiological features of focal-type AIP were also evaluated.
  
  
  METHODS
  We re-evaluated 15 patients who underwent pancreatic resection with a presumed diagnosis of pancreatic ductal adenocarcinoma, and who in the past had been diagnosed pathologically as having chronic pancreatitis.
  
  
  RESULTS
  Seven of 15 patients showed AIP, and the other 8 patients were diagnosed as having mass-forming chronic pancreatitis not otherwise specified by pathological retrospective examination. In other words, nearly half of the cases of resected chronic pancreatitis that were suspected to be pancreatic carcinoma preoperatively showed focal-type AIP. Regarding the characteristic findings of focal-type AIP, narrowing of the pancreatic duct on endoscopic retrograde pancreatography (ERP) might be diagnostic.
  
  
  CONCLUSIONS
  Focal-type AIP is not a rare clinical entity and might be buried in previously resected pancreatic specimens that in the past were diagnosed simply as mass-forming pancreatitis.
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kajiwara
authors.forename: Naoto
authors.initials: N
authors.lastname: Gotohda
authors.forename: Masaru
authors.initials: M
authors.lastname: Konishi
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakagohri
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Takahashi
authors.forename: Motohiro
authors.initials: M
authors.lastname: Kojima
authors.forename: Taira
authors.initials: T
authors.lastname: Kinoshita
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000368:Aged; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000453:epidemiology*; D002908:Chronic Disease; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed