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Journal of Hepato-Biliary-Pancreatic Sciences

Published in:

01-03-2011 | Original article

Autoimmune pancreatitis mimicking pancreatic cancer

Authors: Lindsay S. Robison, Cheri L. Canon, Shyam Varadarajulu, Mohamad A. Eloubeidi, Selwyn Vickers, C. Mel Wilcox

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 2/2011

Abstract

Background/purpose

Autoimmune pancreatitis (AIP) is a form of chronic pancreatitis that can often be difficult to distinguish from pancreatic cancer. We describe the clinical and radiographic features of 23 patients with AIP whose presentations mimicked pancreatic cancer.

Methods

A review of clinic, radiology, and endoscopy records from a 6-year period identified patients with AIP initially suspected of having pancreatic cancer. Abdominal computed tomography (CT) with intravenous contrast, endoscopic ultrasonography (EUS), and/or ERCP was performed in each patient. The diagnosis of AIP was made histologically and/or cytologically for each patient.

Results

Nineteen of 23 patients (83%) presented with new-onset weight loss, jaundice, or both. Nineteen (83%) patients had CT findings worrisome for pancreatic cancer including: (1) pancreatic enlargement or focal mass, (2) regional lymphadenopathy, and/or (3) vascular invasion. Eighteen patients (78%) had common bile duct strictures on ERCP. EUS-guided fine-needle aspiration biopsies excluded pancreatic cancer in all 22 patients who had EUS (96%). Seven patients had surgery for continued suspicion of pancreatic cancer.

Conclusions

Although AIP commonly presents with features suggestive of pancreatic cancer, clinical recognition of AIP with appropriate diagnostic testing including EUS with fine-needle aspiration, ERCP, IgG4 levels, and pancreatic protocol CT expedites diagnosis and can spare patients unnecessary surgery.

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Title: Autoimmune pancreatitis mimicking pancreatic cancer
Authors: Lindsay S. Robison
Cheri L. Canon
Shyam Varadarajulu
Mohamad A. Eloubeidi
Selwyn Vickers
C. Mel Wilcox
Publication date: 01-03-2011
Publisher: Springer Japan
Published in: Journal of Hepato-Biliary-Pancreatic Sciences / Issue 2/2011
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI: https://doi.org/10.1007/s00534-010-0321-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Autoimmune pancreatitis mimicking pancreatic cancer

Abstract

Background/purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background/purpose

Methods

Results

Conclusions

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