Non-alcoholic duct destructive chronic pancreatitis

Abstract

Background-The pathology of nonalcoholic chronic pancreatitis has not yet been suYciently studied. Aims-To identify the major changes of pancreatic tissue in patients surgically treated for non-alcoholic chronic pancreatitis. Patients-Pancreatectomy specimens from 12 patients with non-alcoholic chronic pancreatitis, including four patients with autoimmune or related diseases (Sjögren's syndrome, primary sclerosing cholangitis, ulcerative colitis, and Crohn's disease), were reviewed. Methods-Morphological changes were studied histologically and immunohistochemically (to type inflammatory cells) and compared with the pancreatic alterations found in 12 patients with alcoholic chronic pancreatitis. Results-In patients with non-alcoholic chronic pancreatitis, with or without associated autoimmune or related diseases, pancreatic inflammation particularly involved the ducts, commonly resulting in duct obstruction and occasionally duct destruction. None of these features was seen in alcoholic chronic pancreatitis which, however, showed pseudocysts and calcifications. Conclusion-The pancreatic changes in patients with non-alcoholic chronic pancreatitis clearly diVer from those with alcoholic chronic pancreatitis. The term chronic duct destructive pancreatitis is suggested for this type of pancreatic disease.

Pancreatic exocrine insufficiency in LXRβ −/− mice is associated with a reduction in aquaporin-1 expression

“…Morphological examination of pancreatic sections stained with hematoxylin-eosin ( Fig. 2 A and B) showed the presence of periductal inflammatory infiltrates around large and medium-sized pancreatic ducts, as described in duct destructive chronic pancreatitis in humans (14).…”

Autoimmune pancreatitis in Japan: overview and perspective

“…7b) [57][58][59]. However, caution is advised, in that infiltration of IgG4 positive cells is not specific to AIP but can be seen even in the lesions of pancreatic cancer and alcoholic chronic pancreatitis [58,60]. There are some reports, chiefly from Western countries, describing AIP with unique pathological features distinct from LPSP.…”

Amendment of the Japanese Consensus Guidelines for Autoimmune Pancreatitis, 2013 I. Concept and diagnosis of autoimmune pancreatitis

“…4d); and (v) periductal infiltration of inflammatory cells (Fig. 4e); and the fibrosis associated with prominent infiltration of lymphocytes and plasmacytes [6][7][8][9][10][11][82][83][84][85][86]. When three of the first four (i-iv) histologic items fulfil the Japanese clinical diagnostic criteria (JPS-2011) [10,11] , or three of the last four (ii-v) fulfil the ICDC [9], definitive diagnosis can be made based on histology alone.…”