OBJECTIVES: We investigated the clinical and radiological features of focal mass-forming autoimmune pancreatitis (FMF AIP) to help physicians avoid performing unnecessary surgery because of an improper diagnosis. METHODS: We evaluated 23 patients with chronic inflammatory pancreatic masses and who underwent pancreatectomy for presumed pancreatic cancer from April 1995 to December 2005. These patients were distinguished into 8 FMF AIP patients and 15 ordinary chronic pancreatitis patients through a histological review, along with considering the immunoglobulin G4 staining. Twenty-six randomly selected pancreatic cancer patients were also evaluated as a control group. RESULTS: On the portal venous phase of computed tomography, 6 (85.7%) of 7 FMF AIP patients showed homogeneous enhancement, whereas only 3 chronic pancreatitis patients (25%) and none of the pancreatic cancer patients showed homogeneous enhancement (P < 0.001). None of the FMF AIP patients showed upstream main pancreatic duct dilatation greater than 5 mm or proximal pancreatic atrophy. CONCLUSIONS: For patients with a pancreatic mass, if their radiological images show homogeneous enhancement on the portal venous phase, the absence of significant upstream main pancreatic duct dilatation greater than 5 mm, and the absence of proximal pancreatic atrophy, then conducting further evaluations should be considered to avoid performing unnecessary surgery.
OBJECTIVES: We investigated the clinical and radiological features of focal mass-forming autoimmune pancreatitis (FMF AIP) to help physicians avoid performing unnecessary surgery because of an improper diagnosis. METHODS: We evaluated 23 patients with chronic inflammatory pancreatic masses and who underwent pancreatectomy for presumed pancreatic cancer from April 1995 to December 2005. These patients were distinguished into 8 FMF AIP patients and 15 ordinary chronic pancreatitispatients through a histological review, along with considering the immunoglobulin G4 staining. Twenty-six randomly selected pancreatic cancerpatients were also evaluated as a control group. RESULTS: On the portal venous phase of computed tomography, 6 (85.7%) of 7 FMF AIP patients showed homogeneous enhancement, whereas only 3 chronic pancreatitispatients (25%) and none of the pancreatic cancerpatients showed homogeneous enhancement (P < 0.001). None of the FMF AIP patients showed upstream main pancreatic duct dilatation greater than 5 mm or proximal pancreatic atrophy. CONCLUSIONS: For patients with a pancreatic mass, if their radiological images show homogeneous enhancement on the portal venous phase, the absence of significant upstream main pancreatic duct dilatation greater than 5 mm, and the absence of proximal pancreatic atrophy, then conducting further evaluations should be considered to avoid performing unnecessary surgery.
Authors: Tommaso Maria Manzia; Luca Toti; Ilaria Lenci; Magdy Attia; Laura Tariciotti; Simon R Bramhall; John A C Buckels; Darius F Mirza Journal: Ann R Coll Surg Engl Date: 2010-05 Impact factor: 1.891
Authors: Sebastian G de la Fuente; Eugene P Ceppa; Srinevas K Reddy; Bryan M Clary; Douglas S Tyler; Theodore N Pappas Journal: J Gastrointest Surg Date: 2010-04-28 Impact factor: 3.452