Autoimmune Pancreatitis: Imaging Features

Sahani, Dushyant V.; Kalva, Sanjeeva P.; Farrell, James J.; Maher, Michael M.; Saini, Sanjay; Müeller, Peter R.; Lauwers, Gregory Y.; Vilas, Carlos; Warshaw, Andrew L.; Simeone, Joseph F.

doi:10.1148/radiol.2332031436

Cited by 369 publications

(284 citation statements)

References 18 publications

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“…2a, b) [31][32][33][34][35]. Irrespective of diffuse or localized enlargement of the pancreas, the involved area is seen as slightly low density compared with the uninvolved area in early images, with increases in density in delayed images.…”

Section: Computed Tomographymentioning

confidence: 99%

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Autoimmune pancreatitis in Japan: overview and perspective

Shimosegawa

Kanno

2009

J Gastroenterol

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Since the rediscovery and definition of autoimmune pancreatitis (AIP) by Yoshida et al. in 1995, the disease has been attracting attention because of its unique clinical features and practical issues. This disease shows very impressive imaging findings, serological changes, and characteristic histopathology. It occurs most commonly in elderly males with painless jaundice or mild abdominal pain; resemblance in imaging findings between AIP and pancreatobiliary cancers poses an important practical issue of differentiation. With increasing recognition of AIP and accumulation of cases, another important feature of this disease has been revealed, i.e

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Section: Computed Tomographymentioning

confidence: 99%

“…The signal intensity in T2-weighted images is variable depending on the amount of fibrosis (Fig. 3a) [31][32][33][34][35]. As in the case of CT, the characteristic finding of AIP is delayed enhancement of the involved area on dynamic magnetic resonance imaging (MRI).…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Autoimmune pancreatitis in Japan: overview and perspective

Shimosegawa

Kanno

2009

J Gastroenterol

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“…This non-invasive approach is useful not only for evaluating the location, distribution, and degree of the biliary strictures by MR cholangiopancreatography, but also for demonstrating other abnormalities such as bile duct wall thickening and unusual enhancement patterns using pre-contrast and dynamic contrast-enhanced MR images. In patients with concomitant AIP, the pancreas shows imaging abnormalities highly specific for the diagnosis (e.g., diffuse enlargement, capsule-like rim around the pancreas, and irregular narrowing of the main pancreatic duct) [39,40]; therefore, the diagnostic approach needs to primarily target the pancreatic lesion. CT and MR imaging also sometimes depict IgG4-RD in other intra-abdominal organs unexpectedly.…”

Section: Ct/mrmentioning

confidence: 99%

IgG4-related sclerosing cholangitis: all we need to know

2016

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Our knowledge and experience of IgG4-related sclerosing cholangitis (ISC) have expanded in the last decade. ISC is one of the common organ manifestations of IgG4-related disease (IgG4-RD); approximately 60 % of patients with this systemic condition have ISC in the proximal and/or distal bile ducts. ISC needs to be discriminated from primary sclerosing cholangitis, cholangiocarcinoma, and other rare forms of lymphoplasmacytic cholangiopathy (e.g., follicular cholangitis and sclerosing cholangitis with granulocytic epithelial lesions). Its diagnosis requires a multidisciplinary approach, in which serology, histology, and imaging play crucial roles. Treatments with high-dose corticosteroids typically lead to the rapid and consistent induction of disease remission. Another promising therapeutic approach is B-cell depletion with rituximab. Although disease relapse is relatively common, provided that appropriate treatments are administered, ISC is considered a ''benign'' disease with a low risk of liver failure and biliary malignancy. Its molecular pathology is characterized by Th2-dominant immune reactions, regulatory T-cell activation, and CCL1-CCR8 interactions. Particular subsets of B cells such as plasmablasts and regulatory B cells also expand. A recent global proteomic study demonstrated that three significantly activated immunological cascades in ISC were all B-cell-or immunoglobulin-related (Fc-gamma receptormediated phagocytosis, B-cell receptor signaling pathway, and Fc-epsilon receptor I signaling pathway), suggesting the crucial roles of B cells in the underlying immune reactions. Despite the expansion of our knowledge of the pathophysiology of ISC, the exact role of IgG4 remains unclear. A better understanding of its immunopathology will offer some potential drug targets for this emerging biliary disease.

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“…Mediante TAC, antes del tratamiento con corticoides, puede observarse un aumento difuso, homogéneo, hipodenso del páncreas, con pérdida del carácter lobulado, semejante a una salchicha cuando está todo el páncreas afectado (en el 26 al 56% de los casos) (25,39,44) (Fig. 2B), pudiendo presentar característicamente un borde liso de baja densidad (Fig.…”

Section: Parénquima Pancreáticounclassified

“…3I). En otros casos, en el 28 al 50%, el aumento puede ser focal, especialmente en la cabeza del páncreas, en forma de una masa con baja atenuación, denominada por algunos autores pancreatitis tumefactiva (25,32,44,45) (Fig. 2A), lo que, unido a la frecuente aparición del aumento del tamaño de los ganglios regionales, hace que se plantee habitualmente un problema de diagnóstico diferencial con el cáncer de páncreas (11).…”

Section: Parénquima Pancreáticounclassified

Pancreatitis crónica autoinmune

Quereda¹

2008

Rev. esp. enferm. dig.

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Autoimmune Pancreatitis: Imaging Features

Cited by 369 publications

References 18 publications

Autoimmune pancreatitis in Japan: overview and perspective

Autoimmune pancreatitis in Japan: overview and perspective

IgG4-related sclerosing cholangitis: all we need to know

Pancreatitis crónica autoinmune

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