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Differentiation of focal autoimmune pancreatitis from pancreatic ductal adenocarcinoma

  • Special Section: Pancreatitis
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Abstract

Autoimmune pancreatitis (AIP) is an inflammatory process of the pancreas that occurs most commonly in elderly males and clinically can mimic pancreatic adenocarcinoma and present with jaundice, weight loss, and abdominal pain. Mass-forming lesions in the pancreas are seen in the focal form of AIP and both clinical and imaging findings can overlap those of pancreatic cancer. The accurate distinction of AIP from pancreatic cancer is of utmost importance as it means avoiding unnecessary surgery in AIP cases or inaccurate steroid treatment in patients with pancreatic cancer. Imaging concomitantly with serological examinations (IgG4 and Ca 19-9) plays an important role in the distinction between these entities. Characteristic extra-pancreatic manifestations as well as favorable good response to treatment with steroids are characteristic of AIP. This paper will review current diagnostic parameters useful in differentiating between focal AIP and pancreatic adenocarcinoma.

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  1. Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA

    Camila Lopes Vendrami, Joon Soo Shin, Nancy A. Hammond, Kunal Kothari & Frank H. Miller

  2. Department of Radiology and Imaging, Medical College of Georgia, 1120 15th Street BA-1411, Augusta, GA, 30912, USA

    Pardeep K. Mittal

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  1. Camila Lopes Vendrami
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Lopes Vendrami, C., Shin, J.S., Hammond, N.A. et al. Differentiation of focal autoimmune pancreatitis from pancreatic ductal adenocarcinoma. Abdom Radiol 45, 1371–1386 (2020). https://doi.org/10.1007/s00261-019-02210-0

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