2021 Volume 36 Issue 4 Pages 212-219
Current situations and problems, including a global comparison, for the pathological diagnosis of pancreatitis were discussed. The international consensus diagnostic criteria (ICDC) are used for the diagnosis of autoimmune pancreatitis (AIP). Japanese AIP clinical diagnostic criteria 2018 is also based on the ICDC, but some of the histological criteria were changed in view of the biopsy diagnosis. In order to cope with an increasing volume of pancreatic biopsies, guidance for diagnosing AIP with biopsy tissue was published in Japan. The diagnostic hallmark of type 2 AIP is the granulocytic epithelial lesion (GEL). The GEL is primarily a finding in the interlobular pancreatic ducts, but there is no consensus on whether lesions in the lobules, which are usually obtained at biopsy, can be regarded as a GEL. Guidelines for the histopathology of chronic pancreatitis established by the working group for the international consensus guidelines for chronic pancreatitis were published, and current issues in the histological diagnosis of chronic pancreatitis were stated with agreement of pathologists. Issues that remain to be solved include histological findings in early chronic pancreatitis and exclusion of asymptomatic fibrosis.
