CC BY-NC-ND 4.0 · Journal of Gastrointestinal and Abdominal Radiology 2021; 04(02): 154-160
DOI: 10.1055/s-0041-1722813
Case Report

Mass Mimicking Autoimmune Pancreatitis—A Report of Two Cases and Review of Literature

Diva S. Shah
1   Department of Radiology, HCG Cancer Centre, Ahmedabad, Gujarat, India
,
Bharat Prajapati
2   GI Onco-Surgery Department, HCG Cancer Centre, Ahmedabad, Gujarat, India
,
Kintan Sanghavi
3   Department of Histopathology and Cytology, Strand Life Science, Ahmedabad, Gujarat, India
,
Shubhda Kanhere
3   Department of Histopathology and Cytology, Strand Life Science, Ahmedabad, Gujarat, India
,
Jagdish Kothari
2   GI Onco-Surgery Department, HCG Cancer Centre, Ahmedabad, Gujarat, India
,
Jignesh Dubal
4   Department of Radiology, HCG Cancer Centre, Ahmedabad, Gujarat, India
› Author Affiliations

Abstract

Autoimmune pancreatitis (AIP) consists of two clinically histologically distinct forms (type I and II) of chronic pancreatitis that are histologically different. These forms of AIP classically respond to oral steroids. The focal form of AIP resembles pancreatic carcinoma both clinically and radiologically and it is of utmost importance to make an early correct diagnosis between these two diseases in order to identify the optimal therapeutic strategy and to avoid unnecessary laparotomy or pancreatic resection in AIP patients. Here we report focal forms of type I and II AIP with clinical and imaging features closely mimicking pancreatic carcinoma.



Publication History

Article published online:
03 March 2021

© 2021. Indian Society of Gastrointestinal and Abdominal Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Sarles H, Sarles JC, Muratore R, Guien C. Chronic inflammatory sclerosis of the pancreas–an autonomous pancreatic disease?. Am J Dig Dis 1961; 6 (07) 688-698
  • 2 Yoshida K, Toki F, Takeuchi T, Watanabe S, Shiratori K, Hayashi N. Chronic pancreatitis caused by an autoimmune abnormality. Proposal of the concept of autoimmune pancreatitis. Dig Dis Sci 1995; 40 (07) 1561-1568
  • 3 Khandelwal A, Inoue D, Takahashi N. Autoimmune pancreatitis: an update. Abdom Radiol (NY) 2020; 45 (05) 1359-1370 [Internet]
  • 4 Kim KP, Kim MH, Song MH, Lee SS, Seo DW, Lee SK. Autoimmune chronic pancreatitis. Am J Gastroenterol 2004; 99 (08) 1605-1616
  • 5 Chari ST. Diagnosis of autoimmune pancreatitis using its five cardinal features: introducing the Mayo Clinic’s HISORt criteria. J Gastroenterol 2007; 42 (Suppl. 18) 39-41
  • 6 Yadav D, Notahara K, Smyrk TC. et al. Idiopathic tumefactive chronic pancreatitis: clinical profile, histology, and natural history after resection. Clin Gastroenterol Hepatol 2003; 1 (02) 129-135
  • 7 Psarras K, Baltatzis ME, Pavlidis ET, Lalountas MA, Pavlidis TE, Sakantamis AK. Autoimmune pancreatitis versus pancreatic cancer: a comprehensive review with emphasis on differential diagnosis. Hepatobiliary Pancreat Dis Int 2011; 10 (05) 465-473
  • 8 Okazaki K, Chiba T. Autoimmune related pancreatitis. Gut 2002; 51 (01) 1-4
  • 9 Lo RSC, Singh RK, Austin AS, Freeman JG. Autoimmune pancreatitis presenting as a pancreatic mass mimicking malignancy. Singapore Med J 2011; 52 (04) e79-e81
  • 10 Chari ST, Kloeppel G, Zhang L, Notohara K, Lerch MM, Shimosegawa T. Histopathologic and clinical subtypes of autoimmune pancreatitis: the Honolulu consensus document. Pancreatology 2010; 10 (06) 664-672
  • 11 Crosara S, D’Onofrio M, De Robertis R. et al. Autoimmune pancreatitis: multimodality non-invasive imaging diagnosis. World J Gastroenterol 2014; 20 (45) 16881-16890
  • 12 Gill M, Brar K, Godara R. et al. Autoimmune pancreatitis masquerading as carcinoma head of pancreas: a case report and review of literature. Ann Med Surg (Lond) 2019; 45: 82-85
  • 13 Shimosegawa T, Chari ST, Frulloni L. et al; International Association of Pancreatology. International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the International Association of Pancreatology. Pancreas 2011; 40 (03) 352-358
  • 14 Van Moerkercke W, Verhamme M, Doubel P, Meeus G, Oyen R, Van Steenbergen W. Autoimmune pancreatitis and extrapancreatic manifestations of IgG4-related sclerosing disease. Acta Gastroenterol Belg 2010; 73 (02) 239-246
  • 15 Cao Z, Tian R, Zhang T, Zhao Y. Localized autoimmune pancreatitis: report of a case clinically mimicking pancreatic cancer and a literature review. Medicine (Baltimore) 2015; 94 (42) e1656
  • 16 Muhi A, Ichikawa T, Motosugi U. 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 2012; 35 (04) 827-836
  • 17 Vijayakumar A, Vijayakumar A. Imaging of focal autoimmune pancreatitis and differentiating it from pancreatic cancer. ISRN Radiol 2013; 2013: 569489
  • 18 Wakabayashi T, Kawaura Y, Satomura Y. et al. Clinical and imaging features of autoimmune pancreatitis with focal pancreatic swelling or mass formation: comparison with so-called tumor-forming pancreatitis and pancreatic carcinoma. Am J Gastroenterol 2003; 98 (12) 2679-2687
  • 19 Kamisawa T, Takuma K, Anjiki H. et al. Differentiation of autoimmune pancreatitis from pancreatic cancer by diffusion-weighted MRI. Am J Gastroenterol 2010; 105 (08) 1870-1875 [Internet]
  • 20 Negrelli R, Boninsegna E, Avesani G. et al. Type 1 and type 2 autoimmune pancreatitis: distinctive clinical and pathological features, but are there any differences at magnetic resonance? Experience from a referral center. Pancreas 2018; 47 (09) 1115-1122
  • 21 Chhoda A, Rustagi T. EUS-guided needle biopsy for autoimmune pancreatitis. Clin J Gastroenterol 2020; 13 (05) 669-677 [Internet]
  • 22 Gardner TB, Chari ST. Autoimmune pancreatitis. Gastroenterol Clin North Am 2008; 37 (02) 439-460, vii
  • 23 Hart PA, Kamisawa T, Brugge WR. et al. Long-term outcomes of autoimmune pancreatitis: a multicentre, international analysis. Gut 2013; 62 (12) 1771-1776