Annals of Nuclear Medicine

, Volume 22, Issue 3, pp 215–219 | Cite as

Extrapancreatic F-18 FDG accumulation in autoimmune pancreatitis

  • Motohiro Sato
  • Toshiyuki Okumura
  • Yasukazu Shioyama
  • Jyouji Imura
Case Report


We report two cases of autoimmune pancreatitis (AIP) in which fluorine-18 fluorodeoxyglucose (FDG) showed moderate accumulation in the pancreas, as well as in bilateral submandibular glands and in multifocal lymph nodes. FDG positron emission tomography (PET)/computed tomography (CT) is a useful diagnostic tool to assess the extrapancreatic lesions of AIP, which is a recently proposed new clinicopathological entity named immunoglobulin G4 (IgG4)-related systemic disease. Recognition of the FDG-PET/CT findings of IgG4-related sclerosing disease is crucial to avoid unnecessary surgery or other intervention because of similarities to malignant lymphoma or malignant tumor with multiple lymph node metastases.


Autoimmune pancreatitis (AIP) Sclerosing sialoadenitis IgG4-related sclerosing disease Positron emission tomography (PET) Fluorine-18 fluorodeoxyglucose (F-18 FDG) 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Yoshida K, Toki F, Takeuchi T, Watanabe S, Shiratori K, Hayashi N, et al. Chronic pancreatitis caused by an autoimmune abnormality: proposal of the concept of autoimmune pancreatitis. Dig Dis Sci 1995;40:1561–1568.PubMedCrossRefGoogle Scholar
  2. 2.
    Hamano H, Kawa S, Horiuchi A, Ueno H, Furuya N, Akamatsu T, et al. High serum IgG4 concentration in patients with sclerosing pancretitis. N Engl J Med 2001;344:732–738.PubMedCrossRefGoogle Scholar
  3. 3.
    Kamisawa T, Funata N, Hayashi Y, Eishi Y, Koike M, Tsuruta K, et al. A new clinicopathological entity of IgG4-related autoimmune disease. J Gastroenterol 2000;38:982–984.CrossRefGoogle Scholar
  4. 4.
    Kamisawa T, Okamoto A. Autoimmune pancreatitis: proposal of IgG4-related sclerosing disease. J Gastroenterol 2006;41:613–625.PubMedCrossRefGoogle Scholar
  5. 5.
    Nakamoto Y, Sakahara H, Higashi T, Saga T, Sato N, Okazaki K, et al. Autoimmune pancreatitis with F-18 fluoro-2-deoxy-d-glucose PET findings. Clin Nucl Med 1999;24:778–780.PubMedCrossRefGoogle Scholar
  6. 6.
    Nakamoto Y, Saga T, Ishimori T, Higashi T, Mamede M, Okazaki K, et al. FDG-PET of autoimmune-related pancreatitis: preliminary results. Eur J Nucl Med 2000;27:1835–1838.PubMedCrossRefGoogle Scholar
  7. 7.
    Okazaki K, Kawa S, Kamisawa T, Naruse S, Tanaka S, Nishimori I, et al. Clinical diagnostic criteria of autoimmune pancreatitis: revised proposal. J Gastroenterol 2006;41:626–631.PubMedCrossRefGoogle Scholar
  8. 8.
    Saeki T, Saito A, Hiura T, Yamazaki H, Emura I, Ueno M, et al. Lymphoplasmacytic infiltration of multiple organs with immunoreactivity for IgG4: IgG4-related systemic disease. Intern Med 2006;45:163–167.PubMedCrossRefGoogle Scholar
  9. 9.
    Irie H, Honda H, Baba S, Kuroiwa T, Yoshimitsu K, Tajima T, et al. Autoimmune pancreatitis: CT and MR characteristics. AJR 1998;170:1323–1327.PubMedGoogle Scholar
  10. 10.
    Sahanl DV, Kalva PK, Farrell J, Maher MM, Saini S, Mueller PR, et al. Autoimmune pancreatitis: imaging features. Radiology 2004;233:345–352.CrossRefGoogle Scholar
  11. 11.
    Takahashi N, Kawashima A, Fletcher JG, Chari ST. Renal involvement in patients with autoimmune pancreatitis: CT and MR imaging findings. Radiology 2007;242:791–801.PubMedCrossRefGoogle Scholar
  12. 12.
    Kanno A, Satoh K, Kimura K, Masamune A, Asakura T, Unno M, et al. Autoimmune pancreatitis with hepatic inflammatory pseudotumor. Pancreas 2005;31:420–423.PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Society of Nuclear Medicine 2008

Authors and Affiliations

  • Motohiro Sato
    • 1
  • Toshiyuki Okumura
    • 1
  • Yasukazu Shioyama
    • 1
  • Jyouji Imura
    • 2
  1. 1.Department of RadiologyIbaraki Prefectural Central HospitalIbarakiJapan
  2. 2.Department of PathologyIbaraki Prefectural Central HospitalIbarakiJapan

Personalised recommendations