The clinical and radiological characteristics of focal mass-forming autoimmune pancreatitis: comparison with chronic pancreatitis and pancreatic cancer.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Chang
Woo Ik
WI
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kim
Beom Jin
BJ
Lee
Jong Kyun
JK
Kang
Pung
P
Lee
Kwang Hyuck
KH
Lee
Kyu Taek
KT
Rhee
Jong Chul
JC
Jang
Kee-Taek
KT
Choi
Seong Ho
SH
Choi
Dong Wook
DW
Choi
Dong Il
DI
Lim
Jae Hoon
JH
D000368:Aged; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000276:immunology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D010180:Pancreatectomy / Q000592:standards; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D050500:Pancreatitis, Chronic / Q000175:diagnosis* / Q000276:immunology / Q000601:surgery; D014057:Tomography, X-Ray Computed
D007074:Immunoglobulin G