Type 1 Autoimmune Pancreatitis Extending along the Main Pancreatic Duct: IgG4-related Pancreatic Periductitis

We herein report a unique form of autoimmune pancreatitis (AIP) spreading along the main pancreatic duct (MPD). A 70-year-old man was referred for a small lesion at the pancreatic neck, accompanying an adjacent cyst and dilated upstream MPD. Four years earlier, health checkup images had shown a panc...

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Published inInternal Medicine Vol. 60; no. 5; pp. 739 - 744
Main Authors Sato, Junya, Matsubayashi, Hiroyuki, Ishiwatari, Hirotoshi, Satoh, Tatsunori, Kaneko, Junichi, Ishikawa, Kazuma, Yoshida, Masao, Takizawa, Kohei, Yabuuchi, Yohei, Kishida, Yoshihiro, Imai, Kenichiro, Hotta, Kinichi, Uesaka, Katsuhiko, Sasaki, Keiko, Ono, Hiroyuki
Format Journal Article
LanguageEnglish
Published Japan The Japanese Society of Internal Medicine 01.03.2021
Japan Science and Technology Agency
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Summary:We herein report a unique form of autoimmune pancreatitis (AIP) spreading along the main pancreatic duct (MPD). A 70-year-old man was referred for a small lesion at the pancreatic neck, accompanying an adjacent cyst and dilated upstream MPD. Four years earlier, health checkup images had shown a pancreatic cyst but no mass lesion. Endoscopic ultrasonography showed a contrast-enhanced, tumorous lesion, mainly occupying the MPD. With a preoperative diagnosis of ductal neoplasms mainly spreading in the MPD, Whipple's resection was performed. The resected specimens showed MPD periductitis with IgG4-related pathology, indicating type 1 AIP. Clinicians should practice caution concerning the various AIP forms.
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Correspondence to Dr. Hiroyuki Matsubayashi, h.matsubayashi@scchr.jp
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.5754-20