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Autoimmune (IgG4) Pancreatitis
Siva P. Raman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          TERMINOLOGY

          • Abbreviations

            • Autoimmune pancreatitis (AIP)
          • Synonyms

            • Lymphoplasmacytic sclerosing pancreatitis; primary sclerosing pancreatitis; tumefactive pancreatitis; non-alcoholic destructive pancreatitis
          • Definitions

            • Immune-mediated fibroinflammatory disease primarily involving pancreas responding to steroid therapy

          IMAGING

          • General Features

            • Imaging Recommendations

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Nuclear Medicine Findings

                      • Other Modality Findings

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Graziani R et al: Autoimmune pancreatitis: multidetector-row computed tomography (MDCT) and magnetic resonance (MR) findings in the Italian experience. Radiol Med. ePub, 2014
                                              2. Khandelwal A et al: Recent advances in the diagnosis and management of autoimmune pancreatitis. AJR Am J Roentgenol. 202(5):1007-21, 2014
                                              3. Agrawal S et al: Distinguishing autoimmune pancreatitis from pancreaticobiliary cancers: current strategy. Ann Surg. 255(2):248-58, 2012
                                              4. Alswat K et al: The spectrum of sclerosing cholangitis and the relevance of IgG4 elevations in routine practice. Am J Gastroenterol. 107(1):56-63, 2012
                                              5. Chandrasekhara V et al: Diagnostic endoscopic retrograde pancreatography for autoimmune pancreatitis: one size does not fit all. Gastroenterology. 142(1):180-2, 2012
                                              6. Hur BY et al: Magnetic resonance imaging findings of the mass-forming type of autoimmune pancreatitis: Comparison with pancreatic adenocarcinoma. J Magn Reson Imaging. 36(1):188-97, 2012
                                              7. Muhi A et al: Mass-forming autoimmune pancreatitis and pancreatic carcinoma: differential diagnosis on the basis of computed tomography and magnetic resonance cholangiopancreatography, and diffusion-weighted imaging findings. J Magn Reson Imaging. 35(4):827-36, 2012
                                              8. Nakatani K et al: Utility of FDG PET/CT in IgG4-related systemic disease. Clin Radiol. 67(4):297-305, 2012
                                              9. Sah RP et al: Autoimmune pancreatitis: an update on classification, diagnosis, natural history and management. Curr Gastroenterol Rep. 14(2):95-105, 2012
                                              10. Song TJ et al: Comparison of clinical findings between histologically confirmed type 1 and type 2 autoimmune pancreatitis. J Gastroenterol Hepatol. 27(4):700-8, 2012
                                              11. Sugumar A: Diagnosis and management of autoimmune pancreatitis. Gastroenterol Clin North Am. 41(1):9-22, 2012
                                              12. Takuma K et al: Strategy to differentiate autoimmune pancreatitis from pancreas cancer. World J Gastroenterol. 18(10):1015-20, 2012
                                              13. Zhang L et al: Autoimmune pancreatitis (AIP) type 1 and type 2: an international consensus study on histopathologic diagnostic criteria. Pancreas. 40(8):1172-9, 2011
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Autoimmune pancreatitis (AIP)
                                                      • Synonyms

                                                        • Lymphoplasmacytic sclerosing pancreatitis; primary sclerosing pancreatitis; tumefactive pancreatitis; non-alcoholic destructive pancreatitis
                                                      • Definitions

                                                        • Immune-mediated fibroinflammatory disease primarily involving pancreas responding to steroid therapy

                                                      IMAGING

                                                      • General Features

                                                        • Imaging Recommendations

                                                          • CT Findings

                                                            • MR Findings

                                                              • Ultrasonographic Findings

                                                                • Nuclear Medicine Findings

                                                                  • Other Modality Findings

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Graziani R et al: Autoimmune pancreatitis: multidetector-row computed tomography (MDCT) and magnetic resonance (MR) findings in the Italian experience. Radiol Med. ePub, 2014
                                                                                          2. Khandelwal A et al: Recent advances in the diagnosis and management of autoimmune pancreatitis. AJR Am J Roentgenol. 202(5):1007-21, 2014
                                                                                          3. Agrawal S et al: Distinguishing autoimmune pancreatitis from pancreaticobiliary cancers: current strategy. Ann Surg. 255(2):248-58, 2012
                                                                                          4. Alswat K et al: The spectrum of sclerosing cholangitis and the relevance of IgG4 elevations in routine practice. Am J Gastroenterol. 107(1):56-63, 2012
                                                                                          5. Chandrasekhara V et al: Diagnostic endoscopic retrograde pancreatography for autoimmune pancreatitis: one size does not fit all. Gastroenterology. 142(1):180-2, 2012
                                                                                          6. Hur BY et al: Magnetic resonance imaging findings of the mass-forming type of autoimmune pancreatitis: Comparison with pancreatic adenocarcinoma. J Magn Reson Imaging. 36(1):188-97, 2012
                                                                                          7. Muhi A et al: Mass-forming autoimmune pancreatitis and pancreatic carcinoma: differential diagnosis on the basis of computed tomography and magnetic resonance cholangiopancreatography, and diffusion-weighted imaging findings. J Magn Reson Imaging. 35(4):827-36, 2012
                                                                                          8. Nakatani K et al: Utility of FDG PET/CT in IgG4-related systemic disease. Clin Radiol. 67(4):297-305, 2012
                                                                                          9. Sah RP et al: Autoimmune pancreatitis: an update on classification, diagnosis, natural history and management. Curr Gastroenterol Rep. 14(2):95-105, 2012
                                                                                          10. Song TJ et al: Comparison of clinical findings between histologically confirmed type 1 and type 2 autoimmune pancreatitis. J Gastroenterol Hepatol. 27(4):700-8, 2012
                                                                                          11. Sugumar A: Diagnosis and management of autoimmune pancreatitis. Gastroenterol Clin North Am. 41(1):9-22, 2012
                                                                                          12. Takuma K et al: Strategy to differentiate autoimmune pancreatitis from pancreas cancer. World J Gastroenterol. 18(10):1015-20, 2012
                                                                                          13. Zhang L et al: Autoimmune pancreatitis (AIP) type 1 and type 2: an international consensus study on histopathologic diagnostic criteria. Pancreas. 40(8):1172-9, 2011