title: Retrospective comparison between preoperative diagnosis by International Consensus Diagnostic Criteria and histological diagnosis in patients with focal autoimmune pancreatitis who underwent surgery with suspicion of cancer.
abstract: OBJECTIVE
  The objective of this study was to compare the preoperative diagnosis by International Consensus Diagnostic Criteria (ICDC) with histological diagnosis in patients with focal autoimmune pancreatitis (AIP) who underwent surgery.
  
  
  METHODS
  Thirty patients (type 1 AIP in 23 and type 2 AIP in 7) with a diagnosis of AIP based on histology of surgical specimens were classified according to ICDC based on their preoperative data.
  
  
  RESULTS
  Pancreatic core biopsies and diagnostic steroid trial were not preoperatively performed in any of the patients. Based on preoperative data, ICDC diagnosed 6 patients (20%) as having type 1 AIP and 24 (80%) as probable AIP. Assuming all patients had responded to a steroid trial preoperatively, ICDC would have diagnosed 8 patients (27%) as having type 1 AIP, 4 (13%) as type 2 AIP, 10 as AIP-not otherwise specified (33%), and 8 (27%) as probable AIP. In the hypothetical situation, 7 of 8 type 1 AIP patients and 3 of 3 type 2 AIP patients would have been classified into the correct subtype of AIP.
  
  
  CONCLUSIONS
  A steroid trial enhances the possibility of correctly diagnosing AIP by ICDC despite the lack of histology. However, some patients cannot be diagnosed as having AIP or be classified into the correct subtype without histology.
authors.affiliation: From the *The Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan; †Department of Pathology, Odense University Hospital, Odense, Denmark; Departments of ‡Pathology, §Radiology, and ∥Medicine, Pancreas Center, University of Verona, Verona, Italy; and ¶Department of Pathology, University of Kiel, Kiel, Germany.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Ikeura
authors.forename: Sönke
authors.initials: S
authors.lastname: Detlefsen
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Zamboni
authors.forename: Riccardo
authors.initials: R
authors.lastname: Manfredi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Negrelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Amodio
authors.forename: Francesco
authors.initials: F
authors.lastname: Vitali
authors.forename: Armando
authors.initials: A
authors.lastname: Gabbrielli
authors.forename: Luigi
authors.initials: L
authors.lastname: Benini
authors.forename: Günter
authors.initials: G
authors.lastname: Klöppel
authors.forename: Kazuichi
authors.initials: K
authors.lastname: Okazaki
authors.forename: Italo
authors.initials: I
authors.lastname: Vantini
authors.forename: Luca
authors.initials: L
authors.lastname: Frulloni
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D001327:Autoimmune Diseases / Q000097:blood / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D007074:Immunoglobulin G / Q000097:blood; D007390:International Agencies; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000601:surgery; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis / Q000601:surgery; D057234:Preoperative Period; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D003245:Consensus Statements as Topic
chemical_list: D007074:Immunoglobulin G