title: Differential diagnosis of pancreatobiliary carcinoma from autoimmune pancreatitis-related diseases: a report of three cases.
abstract: BACKGROUND
  "Japanese clinical guidelines for autoimmune pancreatitis" advised to carefully differentiate between two conditions: autoimmune pancreatitis (AIP) and associated sclerosing cholangitis (SC), and pancreatobiliary malignancy.
  
  
  METHODS
  We report a series of three cases for which differential diagnosis of pancreatobiliary carcinoma from AIP and associated SC was crucial.
  
  
  RESULTS
  Three patients presented with biliary stenosis secondary to pancreatic swelling or mass lesion, followed by further examinations: Case 1 was first diagnosed as having tumor-forming pancreatitis associated with AIP but eventually proven to be pancreatic head carcinoma; case 2 was operated for suspected bile duct cancer combined with AIP and associated cholangitis, and early cancer was found in the resected specimen; case 3 was operated on for presumed cholangiocarcinoma combined with AIP-associated SC, but no malignancy was found.
  
  
  CONCLUSIONS
  Current series of cases would raise an alert on diagnosis of AIP and associated SC, and pancreatobiliary malignancy should be carefully excluded by any means. Surgical intervention would be required in selected cases of this clinical entity.
authors.affiliation: Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, 569-8686, Takatsuki City, Osaka, Japan. sur083@poh.osaka-med.ac.jp
authors.forename: Michihiro
authors.initials: M
authors.lastname: Hayashi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Arisaka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takeshita
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tominaga
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ki
authors.forename: Daisuke
authors.initials: D
authors.lastname: Masuda
authors.forename: Fumitoshi
authors.initials: F
authors.lastname: Hirokawa
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Egashira
authors.forename: Motomu
authors.initials: M
authors.lastname: Tsuji
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Tanigawa
mesh_terms: D000368:Aged; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000601:surgery; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015209:Cholangitis, Sclerosing / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D010195:Pancreatitis / Q000175:diagnosis* / Q000601:surgery; D011379:Prognosis; D014057:Tomography, X-Ray Computed