Abstract
There have been only a few reports of autoimmune pancreatitis complicated with pancreatic cyst and such cysts are rare, probably due to the absence of severe tissue necrosis and/or lack of stasis of the pancreatic juice in this condition. However, during a follow-up of 48 patients with this disease, we found 3 patients with pancreatic cysts, and this enabled us to evaluate their clinicopathological findings. Between September 1994 and July 2003, we treated and followed 48 patients with autoimmune pancreatitis, and found 3 patients with pancreatic cyst formation that was responsive to corticosteroid therapy. All of the patients with cysts had high serum IgG4 concentrations. After corticosteroid therapy, rapid resolution of the pancreatic cysts was observed. Immunostaining with goat polyclonal antibody for each IgG subclass showed severe infiltration of IgG4-positive plasma cells in the cyst wall in one patient. The high serum IgG4 concentration and favorable response to corticosteroid therapy suggests that a highly active state of the inflammatory process is closely associated with cyst formation, and that a corticosteroid-responsive pancreatic cyst is a characteristic feature of autoimmune pancreatitis.
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References
K Yoshida F Toki T Takeuchi S Watanabe K Shiratori N Hayashi (1995) ArticleTitleChronic pancreatitis caused by an autoimmune abnormality. Proposal of the concept of autoimmune pancreatitis Dig Dis Sci 40 1561–8 Occurrence Handle7628283
K Kawaguchi M Koike K Tsuruta A Okamoto I Tabata N Fujita (1991) ArticleTitleLymphoplasmacytic sclerosing pancreatitis with cholangitis: a variant of primary sclerosing cholangitis extensively involving pancreas Hum Pathol 22 387–95 Occurrence Handle10.1016/0046-8177(91)90087-6 Occurrence Handle2050373
H Hamano S Kawa A Horiuchi H Unno N Furuya T Akamatsu et al. (2001) ArticleTitleHigh serum IgG4 concentrations in patients with sclerosing pancreatitis N Engl J Med 344 732–8 Occurrence Handle10.1056/NEJM200103083441005 Occurrence Handle11236777
K Okazaki T Chiba (2002) ArticleTitleAutoimmune related pancreatitis Gut 51 1–4 Occurrence Handle10.1136/gut.51.1.1 Occurrence Handle12077078
H Sarles JC Sarles R Muratore C Guien (1961) ArticleTitleChronic inflammatory sclerosis of the pancreas—an autonomous pancreatitis disease? Am J Dig Dis 6 688–98 Occurrence Handle13746542
A Horiuchi T Kaneko N Yamamura A Nagata T Nakamura T Akamatsu et al. (1996) ArticleTitleAutoimmune pancreatitis simulating pancreatic lymphoma Am J Gastroenterol 91 2607–9 Occurrence Handle8946997
T Ito I Nakano S Koyanagi T Miyahara Y Migita K Ogoshi et al. (1997) ArticleTitleAutoimmune pancreatitis as a new clinical entity; three cases of autoimmune pancreatitis with effective steroid therapy Dig Dis Sci 42 1458–68 Occurrence Handle10.1023/A:1018862626221 Occurrence Handle9246047
A Horiuchi S Kawa T Akamatsu Y Aoki K Mukawa N Furuya et al. (1998) ArticleTitleCharacteristic pancreatic duct appearance in autoimmune chronic pancreatitis: a case report and review of the Japanese literature Am J Gastroenterol 93 260–3 Occurrence Handle10.1111/j.1572-0241.1998.00260.x Occurrence Handle9468255
Y Motoo T Minamoto H Watanabe J Sakai T Okai N Sawabu (1997) ArticleTitleSclerosing pancreatitis showing rapidly progressive changes with recurrent mass formation Int J Pancreatol 21 85–90 Occurrence Handle9127178
T Wakabayashi Y Motoo Y Kojima H Makino N Sawabu (1998) ArticleTitleChronic pancreatitis with diffuse irregular narrowing of the main pancreatic duct Dig Dis Sci 43 2415–25 Occurrence Handle10.1023/A:1026621913192 Occurrence Handle9824128
GW Erkelens FP Vleggaar W Lesterhuis HR van Buuren SD van der Werf (1999) ArticleTitleSclerosing pancreatico-cholangitis responsive to steroid therapy Lancet 354 43–4 Occurrence Handle10.1016/S0140-6736(99)00603-0 Occurrence Handle10406367
A Horiuchi S Kawa H Hamano Y Ochi K Kiyosawa (2001) ArticleTitleSclerosing pancreato-cholangitis responsive to corticosteroid therapy: report of two case reports and review Gastrointest Endosc 53 518–22 Occurrence Handle10.1067/mge.2001.110452 Occurrence Handle11275902
I Nishimori K Suda I Oi M Ogawa (2000) ArticleTitleAutoimmune pancreatitis (in Japanese) Jpn J Gastroenterol 97 1355–63
H Kitoh S Kondoh U Naoki H Yamashita H Ozawa T Nakashima et al. (2003) ArticleTitleFocal autoimmune pancreatitis discovered due to the formation of a large pancreatic pseudocyst (in Japanese) Nippon Naika Gakkai Zasshi (the Japanese Society of Internal Medicine) 92 871–3
T Okamoto M Niwakawa T Yasuoka T Kajinami Y Fujiyama T Bamba (2003) ArticleTitleAutoimmune pancreatitis complicated with pseudocyst (in Japanese). A case report J Jpn Pancreas Soc 18 228–34
T Nishimura T Masaoka H Suzuki K Aiura H Nagata H Ishii (2004) ArticleTitleAutoimmune pancreatitis with pseudocysts J Gastroenterol 39 1005–10 Occurrence Handle10.1007/s00535-004-1436-4 Occurrence Handle15549456
H Hamano S Kawa Y Ochi H Unno N Shiba M Wajiki et al. (2002) ArticleTitleHydronephrosis associated with retroperitoneal fibrosis and sclerosing pancreatitis Lancet 359 1403–4 Occurrence Handle10.1016/S0140-6736(02)08359-9 Occurrence Handle11978339
ML Steer I Waxman S Freedman (1995) ArticleTitleChronic pancreatitis N Engl J Med 332 1482–90 Occurrence Handle10.1056/NEJM199506013322206 Occurrence Handle7739686
GJ Vitas MG Sarr (1992) ArticleTitleSelected management of pancreatic pseudocysts: operative versus expectant management Surgery 111 123–30 Occurrence Handle1736380
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Muraki, T., Hamano, H., Ochi, Y. et al. Corticosteroid-responsive pancreatic cyst found in autoimmune pancreatitis. J Gastroenterol 40, 761–766 (2005). https://doi.org/10.1007/s00535-005-1622-z
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DOI: https://doi.org/10.1007/s00535-005-1622-z