Endoscopic approach for diagnosing autoimmune pancreatitis
Endoscopic approach for diagnosing autoimmune pancreatitis作者机构：Department of Internal MedicineTokyo Metropolitan Komagome HospitalTokyo 113-8677Japan Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyo 113-8677Japan
出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)
年 卷 期：2010年第2卷第1期
页 面：20-24页
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
主 题：Autoimmune pancreatitis Pancreatic cancer Endoscopic retrograde cholangiopancreatography Endoscopic ultrasonography-Fine needle aspiration IgG4
摘 要：It is of utmost importance to differentiate autoimmune pancreatitis(AIP) from pancreatic cancer(PC).Segmental AIP cases are sometimes difficult to differentiate from *** endoscopic retrograde cholangio pancreatography,long or skipped irregular narrowing of the main pancreatic duct(MPD),less upstream dilatation of the distal MPD,side branches derived from the narrowed portion of the MPD,absence of obstruction of the MPD,and stenosis of the intrahepatic bile duct suggest AIP rather than *** infiltration of IgG4-positive plasma cells is frequently and rather specifically detected in the major duodenal papilla of AIP ***4-immunostaining of biopsy specimens obtained from the major duodenal papilla is useful for supporting a diagnosis of AIP with pancreatic head *** endoscopic ultrasonography(EUS),hyperechoic spots in the hypoechoic mass and the duct-penetrating sign suggest AIP rather than *** and intraductal ultrasonography sometimes show wall thickening of the common bile duct even in the segment in which abnormalities are not clearly observed with cholangiography in AIP ***-guided fine needle aspiration,especially EUS-guided Tru-Cut biopsy,is useful to diagnose AIP,as well as to exclude PC.
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