Clinical Gastroenterology Vol.25 No.9(9)

Theme Autoimmune Pancreatitis
Title Differential Diagnosis of Autoimmune Pancreatitis and Other Pancreatic Diseases
Publish Date 2010/08
Author Kenji Hirano Department of Gastroenterology, Faculty of Medicine, University of Tokyo
Author Minoru Tada Department of Gastroenterology, Faculty of Medicine, University of Tokyo
Author Hiroyuki Isayama Department of Gastroenterology, Faculty of Medicine, University of Tokyo
Author Naoki Sasahira Department of Gastroenterology, Faculty of Medicine, University of Tokyo
Author Yousuke Nakai Department of Gastroenterology, Faculty of Medicine, University of Tokyo
Author Kazuhiko Koike Department of Gastroenterology, Faculty of Medicine, University of Tokyo
[ Summary ] It is usually possible to differentiate autoimmune pancreatitis (AIP) from other pancreatic diseases, including pancreatic cancer, by employing various modalities. However, first of all, "suspecting AIP" is the most important point for the differentiation. Useful findings for the diagnosis of AIP are 1) elevation of serum IgG4 2) capsule-like rim and delayed enhancement on dynamic CTS and 3) narrowing of the main pancreatic duct with recognizable branch ducts and mild distal dilatation. Although EUS-FNA is also useful for ruling out malignancy, diagnostic steroid administration may often be acceptable in light of possible dissemination in cases with malignancy.
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