Skip to main content
SpringerLink
Log in

Autoimmune Pancreatitis Masquerading as Pancreatic Cancer: when in Doubt, Cut It Out

  • Case Report
  • Published:
Journal of Gastrointestinal Cancer Aims and scope Submit manuscript

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. Brauner E, Lachter J, Ben-Ishay O, Vlodavsky E, Kluger Y. Autoimmune pancreatitis misdiagnosed as a tumor of the head of the pancreas. World journal of gastrointestinal surgery. 2012;4(7):185–9.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Omiyale AO. Autoimmune pancreatitis. Gland surgery. 2016;5(3):318–26.

    Article  PubMed  PubMed Central  Google Scholar 

  3. van Heerde MJ, Biermann K, Zondervan PE, et al. Prevalence of autoimmune pancreatitis and other benign disorders in pancreatoduodenectomy for presumed malignancy of the pancreatic head. Dig Dis Sci. 2012;57(9):2458–65.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Sarles H, Sarles JC, Muratore R, Guien C. Chronic inflammatory sclerosis of the pancreas—an autonomous pancreatic disease? The American journal of digestive diseases. 1961;6:688–98.

    Article  PubMed  CAS  Google Scholar 

  5. Sah RP, Pannala R, Chari ST, et al. Prevalence, diagnosis, and profile of autoimmune pancreatitis presenting with features of acute or chronic pancreatitis. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2010;8(1):91–6.

    Article  Google Scholar 

  6. Kanno A, Nishimori I, Masamune A, et al. Nationwide epidemiological survey of autoimmune pancreatitis in Japan. Pancreas. 2012;41(6):835–9.

    Article  PubMed  Google Scholar 

  7. Nishimori I, Tamakoshi A, Otsuki M, Research Committee on Intractable Diseases of the Pancreas MoHL, Welfare of J. Prevalence of autoimmune pancreatitis in Japan from a nationwide survey in 2002. J Gastroenterol. 2007;42(Suppl 18):6–8.

    Article  PubMed  Google Scholar 

  8. Yadav D, Notahara K, Smyrk TC, et al. Idiopathic tumefactive chronic pancreatitis: clinical profile, histology, and natural history after resection. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2003;1(2):129–35.

    Article  Google Scholar 

  9. Meng Q, Xin L, Liu W, et al. Diagnosis and treatment of autoimmune pancreatitis in China: a systematic review. PLoS One. 2015;10(6):e0130466.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Crist DW, Sitzmann JV, Cameron JL. Improved hospital morbidity, mortality, and survival after the Whipple procedure. Ann Surg. 1987;206(3):358–65.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Ho CK, Kleeff J, Friess H, Buchler MW. Complications of pancreatic surgery. HPB: the official journal of the International Hepato Pancreato Biliary Association. 2005;7(2):99–108.

    Article  Google Scholar 

  12. Sugumar A, Kloppel G, Chari ST. Autoimmune pancreatitis: pathologic subtypes and their implications for its diagnosis. Am J Gastroenterol. 2009;104(9):2308–10. quiz 2311

    Article  PubMed  Google Scholar 

  13. Guarneri F, Guarneri C, Benvenga S. Helicobacter pylori and autoimmune pancreatitis: role of carbonic anhydrase via molecular mimicry? J Cell Mol Med. 2005;9(3):741–4.

    Article  PubMed  CAS  Google Scholar 

  14. Zen Y, Fujii T, Harada K, et al. Th2 and regulatory immune reactions are increased in immunoglobin G4-related sclerosing pancreatitis and cholangitis. Hepatology. 2007;45(6):1538–46.

    Article  PubMed  CAS  Google Scholar 

  15. Ghazale A, Chari ST, Smyrk TC, et al. Value of serum IgG4 in the diagnosis of autoimmune pancreatitis and in distinguishing it from pancreatic cancer. Am J Gastroenterol. 2007;102(8):1646–53.

    Article  PubMed  CAS  Google Scholar 

  16. Chang MC, Chang YT, Tien YW, et al. T-cell regulatory gene CTLA-4 polymorphism/haplotype association with autoimmune pancreatitis. Clin Chem. 2007;53(9):1700–5.

    Article  PubMed  CAS  Google Scholar 

  17. Park DH, Kim MH, Oh HB, et al. Substitution of aspartic acid at position 57 of the DQbeta1 affects relapse of autoimmune pancreatitis. Gastroenterology. 2008;134(2):440–6.

    Article  PubMed  CAS  Google Scholar 

  18. Kawa S, Ota M, Yoshizawa K, et al. HLA DRB10405-DQB10401 haplotype is associated with autoimmune pancreatitis in the Japanese population. Gastroenterology. 2002;122(5):1264–9.

    Article  PubMed  Google Scholar 

  19. Horiuchi A, Kawa S, Hamano H, Hayama M, Ota H, Kiyosawa K. ERCP features in 27 patients with autoimmune pancreatitis. Gastrointest Endosc. 2002;55(4):494–9.

    Article  PubMed  Google Scholar 

  20. Sugumar A, Levy MJ, Kamisawa T, et al. Endoscopic retrograde pancreatography criteria to diagnose autoimmune pancreatitis: an international multicentre study. Gut. 2011;60(5):666–70.

    Article  PubMed  Google Scholar 

  21. Pearson RK, Longnecker DS, Chari ST, et al. Controversies in clinical pancreatology: autoimmune pancreatitis: does it exist? Pancreas. 2003;27(1):1–13.

    Article  PubMed  Google Scholar 

  22. Komatsu K, Hamano H, Ochi Y, et al. High prevalence of hypothyroidism in patients with autoimmune pancreatitis. Dig Dis Sci. 2005;50(6):1052–7.

    Article  PubMed  Google Scholar 

  23. Hamano H, Arakura N, Muraki T, Ozaki Y, Kiyosawa K, Kawa S. Prevalence and distribution of extrapancreatic lesions complicating autoimmune pancreatitis. J Gastroenterol. 2006;41(12):1197–205.

    Article  PubMed  Google Scholar 

  24. Nakazawa T, Ohara H, Yamada T, et al. Atypical primary sclerosing cholangitis cases associated with unusual pancreatitis. Hepato-Gastroenterology. 2001;48(39):625–30.

    PubMed  CAS  Google Scholar 

  25. Topal F, Saritas Yuksel E, Ekinci N, et al. The prevalence of IgG4-positive plasma cell infiltrates in inflammatory bowel disease patients without autoimmune pancreatitis. The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology. 2014;25(5):558–62.

    Article  Google Scholar 

  26. Hamano H, Kawa S, Horiuchi A, et al. High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med. 2001;344(10):732–8.

    Article  PubMed  CAS  Google Scholar 

  27. Sahani DV, Kalva SP, Farrell J, et al. Autoimmune pancreatitis: imaging features. Radiology. 2004;233(2):345–52.

    Article  PubMed  Google Scholar 

  28. Bodily KD, Takahashi N, Fletcher JG, et al. Autoimmune pancreatitis: pancreatic and extrapancreatic imaging findings. Am J Roentgenol. 2009;192(2):431–7.

    Article  Google Scholar 

  29. Manfredi R, Frulloni L, Mantovani W, Bonatti M, Graziani R, Pozzi MR. Autoimmune pancreatitis: pancreatic and extrapancreatic MR imaging-MR cholangiopancreatography findings at diagnosis, after steroid therapy, and at recurrence. Radiology. 2011;260(2):428–36.

    Article  PubMed  Google Scholar 

  30. Irie H, Honda H, Baba S, et al. Autoimmune pancreatitis: CT and MR characteristics. Am J Roentgenol. 1998;170(5):1323–7.

    Article  CAS  Google Scholar 

  31. Pannala R, Chari ST. Corticosteroid treatment for autoimmune pancreatitis. Gut. 2009;58(11):1438–9.

    Article  PubMed  CAS  Google Scholar 

  32. Hart PA, Kamisawa T, Brugge WR, et al. Long-term outcomes of autoimmune pancreatitis: a multicentre, international analysis. Gut. 2013;62(12):1771–6.

    Article  PubMed  Google Scholar 

  33. Kamisawa T, Shimosegawa T, Okazaki K, et al. Standard steroid treatment for autoimmune pancreatitis. Gut. 2009;58(11):1504–7.

    Article  PubMed  CAS  Google Scholar 

  34. Kamisawa T, Imai M, Yui Chen P, et al. Strategy for differentiating autoimmune pancreatitis from pancreatic cancer. Pancreas. 2008;37(3):e62–7.

    Article  PubMed  Google Scholar 

  35. Chari ST, Takahashi N, Levy MJ, et al. A diagnostic strategy to distinguish autoimmune pancreatitis from pancreatic cancer. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2009;7(10):1097–103.

    Article  CAS  Google Scholar 

  36. 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.

    Article  PubMed  Google Scholar 

  37. Otsuki M, Chung JB, Okazaki K, et al. Asian diagnostic criteria for autoimmune pancreatitis: consensus of the Japan–Korea Symposium on Autoimmune pancreatitis. J Gastroenterol. 2008;43(6):403–8.

    Article  PubMed  CAS  Google Scholar 

  38. Shimosegawa T, Chari ST, Frulloni L, et al. International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the International Association of Pancreatology. Pancreas. 2011;40(3):352–8.

    Article  PubMed  Google Scholar 

  39. Zyromski NJ. Autoimmune pancreatitis (AIP) masquerading as pancreatic cancer: cutting is not a crime...for now. Dig Dis Sci. 2012;57(9):2246–7.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Health Sciences North, 41 Ramsey Lake Road, Sudbury, ON, P3E 5J1, Canada

    Henry Y. Jiang, Kengo Asai & Jeffrey B. Shum

  2. Faculty of Medicine, Northern Ontario School of Medicine, Sudbury, ON, Canada

    Henry Y. Jiang, Erica L. Kohtakangas, Bojana Mitrovic, Kengo Asai & Jeffrey B. Shum

  3. Department of Pathology, Health Sciences North, Sudbury, ON, Canada

    Bojana Mitrovic

Authors
  1. Henry Y. Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Erica L. Kohtakangas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bojana Mitrovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kengo Asai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jeffrey B. Shum
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jeffrey B. Shum.

Ethics declarations

The study was approved by our institution ethics review board.

Funding

No funding was received for this study.

Conflict of Interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jiang, H.Y., Kohtakangas, E.L., Mitrovic, B. et al. Autoimmune Pancreatitis Masquerading as Pancreatic Cancer: when in Doubt, Cut It Out. J Gastrointest Canc 49, 365–372 (2018). https://doi.org/10.1007/s12029-017-9924-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12029-017-9924-y

Keywords

Search

Navigation