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Journal of Gastroenterology

, Volume 44, Issue 7, pp 765–773 | Cite as

Diagnostic utility of biopsy specimens for autoimmune pancreatitis

  • Kenji Hirano
  • Noriyoshi Fukushima
  • Minoru Tada
  • Hiroyuki Isayama
  • Suguru Mizuno
  • Keisuke Yamamoto
  • Yoko Yashima
  • Hiroshi Yagioka
  • Takashi Sasaki
  • Hirofumi Kogure
  • Yousuke Nakai
  • Naoki Sasahira
  • Takeshi Tsujino
  • Takao Kawabe
  • Masashi Fukayama
  • Masao Omata
Original Article—Liver, Pancreas, and Biliary Tract

Abstract

Background and aims

Infiltration of IgG4-positive plasma cells in the pancreas and other organs is characteristic of autoimmune pancreatitis (AIP). However, it is undetermined whether needle or forceps biopsy of pancreas or other organs is indeed useful for the diagnosis of AIP. We aimed to clarify this point.

Methods

Among 39 AIP patients, tissue sampling without laparotomy was performed in 27. Biopsy of pancreas, gastric mucosa, liver, bile duct, and duodenal papilla was performed in 15, 17, 11, 5 and 7, respectively. The obtained specimens were examined for IgG4-positive plasma cells. We also examined gastric mucosa of 18 patients with pancreatic cancer as controls. When the number of IgG4-positive plasma cells was more than 10 per high-power field, we regarded it as diagnostic.

Results

Diagnostic sensitivity in pancreas, gastric mucosa, liver, bile duct, and duodenal papilla was 47% (7/15), 47% (8/17), 36% (4/11), 0% (0/5), and 57% (4/7), respectively.

Conclusions

Sensitivity of IgG4 immunostaining was unsatisfactory when tissue sampling was performed by needle or forceps biopsy. Biopsy of gastric mucosa might be a good subsidiary diagnostic tool.

Keywords

Autoimmune pancreatitis IgG4 Plasma cell Biopsy 

Abbreviations

AIP

Autoimmune pancreatitis

SC

Sclerosing cholangitis

LPSP

Lymphoplasmacytic sclerosing pancreatitis

Ig

Immunoglobulin

H&E

Hematoxylin–eosin

EVG

Elastica van Gieson

HPF

High-power field

Helicobacter pylori

H. pylori

Notes

Conflict of interest statement

None to declare.

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Copyright information

© Springer 2009

Authors and Affiliations

  • Kenji Hirano
    • 1
  • Noriyoshi Fukushima
    • 2
  • Minoru Tada
    • 1
  • Hiroyuki Isayama
    • 1
  • Suguru Mizuno
    • 1
  • Keisuke Yamamoto
    • 1
  • Yoko Yashima
    • 1
  • Hiroshi Yagioka
    • 1
  • Takashi Sasaki
    • 1
  • Hirofumi Kogure
    • 1
  • Yousuke Nakai
    • 1
  • Naoki Sasahira
    • 1
  • Takeshi Tsujino
    • 1
  • Takao Kawabe
    • 1
  • Masashi Fukayama
    • 2
  • Masao Omata
    • 1
  1. 1.Department of GastroenterologyUniversity of TokyoBunkyo-kuJapan
  2. 2.Department of Pathology, Faculty of MedicineUniversity of TokyoBunkyo-kuJapan

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