Comparison of histopathological features of pancreatic carcinoma and type 1 autoimmune pancreatitis

Type 1 autoimmune pancreatitis (AIP‐1) is an immunoglobulin G (IgG)‐4‐related disease (IgG4‐RD), characterized by elevated serum immunoglobulin G4 (IgG4) and infiltration by IgG4+ plasma cells. Pancreatic carcinoma (PC) sometimes shows infiltration by IgG4+ plasma cells, but details have been unclea...

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Published inPathology international Vol. 64; no. 2; pp. 51 - 57
Main Authors Uehara, Takeshi, Hamano, Hideaki, Kawa, Shigeyuki, Kobayashi, Yukihiro, Yoshizawa, Akihiko, Oki, Keiko, Nakata, Rie, Kobayashi, Akira, Sano, Kenji, Ota, Hiroyoshi
Format Journal Article
LanguageEnglish
Published Australia Blackwell Publishing Ltd 01.02.2014
Subjects
Aged
Autoimmune Diseases - pathology
Carcinoma - pathology
Diagnosis, Differential
Female
Humans
IgG4+ plasma cell/IgG+ plasma cell ratio
IgG4-related disease
Male
Middle Aged
Pancreas - pathology
pancreatic carcinoma
Pancreatic Neoplasms - pathology
Pancreatitis - pathology
Plasma Cells - pathology
type 1 autoimmune pancreatitis
IgG4+ plasma cell/IgG+ plasma cell ratio
type 1 autoimmune pancreatitis
IgG4-related disease
pancreatic carcinoma
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Abstract Type 1 autoimmune pancreatitis (AIP‐1) is an immunoglobulin G (IgG)‐4‐related disease (IgG4‐RD), characterized by elevated serum immunoglobulin G4 (IgG4) and infiltration by IgG4+ plasma cells. Pancreatic carcinoma (PC) sometimes shows infiltration by IgG4+ plasma cells, but details have been unclear. We compared pathological findings and expression of IgG4 and IgG in fibroses in 18 PC patients to those from 9 AIP‐1 patients. Fibroses were divided into areas of ductal adenocarcinoma (DA) and obstructive pancreatitis (OP). Serum IgG4 levels were lower than the cut‐off value in all PC patients with no IgG4‐RD. Diffuse lymphoplasmacytic infiltration and eosinophil infiltration were characteristic of fibroses in PC. Though AIP‐1 samples often had storiform fibrosis even in biopsies, PC did not show storiform fibrosis. Ratios of IgG4+ plasma cells/IgG+ plasma cells (IgG4/IgG ratios) in DA and OP were significantly lower than in AIP‐1. However, high‐density IgG4+ plasma cell foci were detected in PC fibroses, particularly around peripheral nerves, vessels, and lymphoid follicles; between lobules and invasion fronts; and within neutrophilic abscesses. In conclusion, the IgG4/IgG ratio is useful in distinguishing PC from AIP‐1, and should be evaluated in three or more areas, as PC can show localized high‐density IgG4+ plasma cell areas.
AbstractList Type 1 autoimmune pancreatitis ( AIP ‐1) is an immunoglobulin G ( IgG )‐4‐related disease ( IgG 4‐ RD ), characterized by elevated serum immunoglobulin G 4 ( IgG 4) and infiltration by IgG 4 + plasma cells. Pancreatic carcinoma ( PC ) sometimes shows infiltration by IgG 4 + plasma cells, but details have been unclear. We compared pathological findings and expression of IgG 4 and IgG in fibroses in 18 PC patients to those from 9 AIP ‐1 patients. Fibroses were divided into areas of ductal adenocarcinoma ( DA ) and obstructive pancreatitis ( OP ). Serum IgG 4 levels were lower than the cut‐off value in all PC patients with no IgG 4‐ RD . Diffuse lymphoplasmacytic infiltration and eosinophil infiltration were characteristic of fibroses in PC . Though AIP ‐1 samples often had storiform fibrosis even in biopsies, PC did not show storiform fibrosis. Ratios of IgG 4 + plasma cells/ IgG + plasma cells ( IgG 4/ IgG ratios) in DA and OP were significantly lower than in AIP ‐1. However, high‐density IgG 4 + plasma cell foci were detected in PC fibroses, particularly around peripheral nerves, vessels, and lymphoid follicles; between lobules and invasion fronts; and within neutrophilic abscesses. In conclusion, the IgG 4/ IgG ratio is useful in distinguishing PC from AIP ‐1, and should be evaluated in three or more areas, as PC can show localized high‐density IgG 4 + plasma cell areas.
Type 1 autoimmune pancreatitis (AIP-1) is an immunoglobulin G (IgG)-4-related disease (IgG4-RD), characterized by elevated serum immunoglobulin G4 (IgG4) and infiltration by IgG4(+) plasma cells. Pancreatic carcinoma (PC) sometimes shows infiltration by IgG4(+) plasma cells, but details have been unclear. We compared pathological findings and expression of IgG4 and IgG in fibroses in 18 PC patients to those from 9 AIP-1 patients. Fibroses were divided into areas of ductal adenocarcinoma (DA) and obstructive pancreatitis (OP). Serum IgG4 levels were lower than the cut-off value in all PC patients with no IgG4-RD. Diffuse lymphoplasmacytic infiltration and eosinophil infiltration were characteristic of fibroses in PC. Though AIP-1 samples often had storiform fibrosis even in biopsies, PC did not show storiform fibrosis. Ratios of IgG4(+) plasma cells/IgG(+) plasma cells (IgG4/IgG ratios) in DA and OP were significantly lower than in AIP-1. However, high-density IgG4(+) plasma cell foci were detected in PC fibroses, particularly around peripheral nerves, vessels, and lymphoid follicles; between lobules and invasion fronts; and within neutrophilic abscesses. In conclusion, the IgG4/IgG ratio is useful in distinguishing PC from AIP-1, and should be evaluated in three or more areas, as PC can show localized high-density IgG4(+) plasma cell areas.
Author Kawa, Shigeyuki
Yoshizawa, Akihiko
Sano, Kenji
Ota, Hiroyoshi
Kobayashi, Akira
Hamano, Hideaki
Nakata, Rie
Kobayashi, Yukihiro
Uehara, Takeshi
Oki, Keiko
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  organization: First Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
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Keywords IgG4+ plasma cell/IgG+ plasma cell ratio
type 1 autoimmune pancreatitis
IgG4-related disease
pancreatic carcinoma
Language English
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Snippet Type 1 autoimmune pancreatitis (AIP‐1) is an immunoglobulin G (IgG)‐4‐related disease (IgG4‐RD), characterized by elevated serum immunoglobulin G4 (IgG4) and...
Type 1 autoimmune pancreatitis (AIP-1) is an immunoglobulin G (IgG)-4-related disease (IgG4-RD), characterized by elevated serum immunoglobulin G4 (IgG4) and...
Type 1 autoimmune pancreatitis ( AIP ‐1) is an immunoglobulin G ( IgG )‐4‐related disease ( IgG 4‐ RD ), characterized by elevated serum immunoglobulin G 4 (...
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SubjectTerms Aged
Autoimmune Diseases - pathology
Carcinoma - pathology
Diagnosis, Differential
Female
Humans
IgG4+ plasma cell/IgG+ plasma cell ratio
IgG4-related disease
Male
Middle Aged
Pancreas - pathology
pancreatic carcinoma
Pancreatic Neoplasms - pathology
Pancreatitis - pathology
Plasma Cells - pathology
type 1 autoimmune pancreatitis
Title Comparison of histopathological features of pancreatic carcinoma and type 1 autoimmune pancreatitis
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https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fpin.12136
https://www.ncbi.nlm.nih.gov/pubmed/24629172
https://search.proquest.com/docview/1508424688
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