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Diagnostic utility of biopsy specimens for autoimmune pancreatitis

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

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.

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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

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Conflict of interest statement

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Authors and Affiliations

  1. Department of Gastroenterology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Kenji Hirano, Minoru Tada, Hiroyuki Isayama, Suguru Mizuno, Keisuke Yamamoto, Yoko Yashima, Hiroshi Yagioka, Takashi Sasaki, Hirofumi Kogure, Yousuke Nakai, Naoki Sasahira, Takeshi Tsujino, Takao Kawabe & Masao Omata

  2. Department of Pathology, Faculty of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan

    Noriyoshi Fukushima & Masashi Fukayama

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  1. Kenji Hirano
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  2. Noriyoshi Fukushima
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  3. Minoru Tada
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  16. Masao Omata
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Correspondence to Kenji Hirano.

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Hirano, K., Fukushima, N., Tada, M. et al. Diagnostic utility of biopsy specimens for autoimmune pancreatitis. J Gastroenterol 44, 765–773 (2009). https://doi.org/10.1007/s00535-009-0052-8

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  • DOI: https://doi.org/10.1007/s00535-009-0052-8

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