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

Junya Sato; Hiroyuki Matsubayashi; Hirotoshi Ishiwatari; Tatsunori Satoh; Junichi Kaneko; Kazuma Ishikawa; Masao Yoshida; Kohei Takizawa; Yohei Yabuuchi; Yoshihiro Kishida; Kenichiro Imai; Kinichi Hotta; Katsuhiko Uesaka; Keiko Sasaki; Hiroyuki Ono

doi:10.2169/internalmedicine.5754-20

This article has now been updated. Please use the final version.

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

Junya Sato, Hiroyuki Matsubayashi, Hirotoshi Ishiwatari, Tatsunori Satoh, Junichi Kaneko, Kazuma Ishikawa, Masao Yoshida, Kohei Takizawa, Yohei Yabuuchi, Yoshihiro Kishida, Kenichiro Imai, Kinichi Hotta, Katsuhiko Uesaka, Keiko Sasaki, Hiroyuki Ono

Author information

Junya Sato
Division of Endoscopy, Shizuoka Cancer Center, Japan
Hiroyuki Matsubayashi
Division of Endoscopy, Shizuoka Cancer Center, Japan
Division of Genetic Medicine Promotion, Shizuoka Cancer Center, Japan
Hirotoshi Ishiwatari
Division of Endoscopy, Shizuoka Cancer Center, Japan
Tatsunori Satoh
Division of Endoscopy, Shizuoka Cancer Center, Japan
Junichi Kaneko
Division of Endoscopy, Shizuoka Cancer Center, Japan
Kazuma Ishikawa
Division of Endoscopy, Shizuoka Cancer Center, Japan
Masao Yoshida
Division of Endoscopy, Shizuoka Cancer Center, Japan
Kohei Takizawa
Division of Endoscopy, Shizuoka Cancer Center, Japan
Yohei Yabuuchi
Division of Endoscopy, Shizuoka Cancer Center, Japan
Yoshihiro Kishida
Division of Endoscopy, Shizuoka Cancer Center, Japan
Kenichiro Imai
Division of Endoscopy, Shizuoka Cancer Center, Japan
Kinichi Hotta
Division of Endoscopy, Shizuoka Cancer Center, Japan
Katsuhiko Uesaka
Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Japan
Keiko Sasaki
Division of Pathology, Shizuoka Cancer Center, Japan
Hiroyuki Ono
Division of Endoscopy, Shizuoka Cancer Center, Japan

Keywords: autoimmune pancreatitis, IgG4, periductitis, intraductal neoplasms, diagnosis

JOURNAL OPEN ACCESS Advance online publication

Article ID: 5754-20

DOI https://doi.org/10.2169/internalmedicine.5754-20

The final version of this article is now available: Vol. 60 (2021), No. 5 pp. 739-744

Details

Abstract

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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