EUS Features



Autoimmune pancreatitis (AIP) is a form of pancreatitis that often demonstrates distinct clinical, serological, histological, and imaging features. A hallmark of this disorder is a rapid and dramatic response to steroid therapy. Following the first description by Sarles [1] in 1961, subsequent reports included only patients with florid disease manifestations [2–4]. As initially described, patients presented with jaundice and a pancreatic head mass that was often incorrectly diagnosed as carcinoma, thereby leading to unnecessary operative intervention. Over time there has been a greater understanding of the diverse clinical, laboratory, and histological manifestations, leading to a more comprehensive set of diagnostic criteria that now allow diagnosis of a broader spectrum of AIP patients while maintaining diagnostic specificity. It is now recognized that AIP represents only one component of a systemic fibroinflammatory disease process termed IgG4-related diseases (IgG4-RD) that also afflicts other organs including the bile duct, lungs, thyroid, retroperitoneum, lymph nodes, salivary glands, and kidneys [5–11]}. These non-pancreatic sites of disease also demonstrate lymphoplasmacytic infiltration with IgG4-positive cells and often storiform fibrosis.

The purpose of this chapter is to review the breadth of endoscopic ultrasound (EUS) findings associated with AIP and to consider the EUS features in the context of clinical, imaging, histological, and laboratory data. We also suggest a role for EUS imaging and guided tissue sampling within the diagnostic algorithm.


Pancreatic Carcinoma Lymphoplasmacytic Infiltration Japan Pancreas Society Idiopathic Duct Centric Chronic Pancreatitis Storiform Fibrosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Division of Gastroenterology and HepatologyMayo ClinicRochesterUSA
  2. 2.Harvard Medical SchoolMassachusetts General HospitalBostonUSA

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