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| A rare case of IgG4-related pancreatitis diagnosed preoperatively by endoscopic ultrasound-guided fine needle aspiration |
| Jun-Feng Zhou, Zhong Chen ∗ |
Department of Hepatobiliary Surgery, The 960th Hospital of PLA, Jinan 250031, China
∗ Corresponding author.
E-mail address: 276290546@qq.com (Z. Chen). |
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Abstract Immunoglobulin G4-related disease (IgG4-RD) can affect organs and tissues throughout the body. IgG4-related pancreatitis, also called type 1 autoimmune pancreatitis (AIP), occurs in 60% of patients with IgG4-RD [1] . IgG4-related pancreatitis is a general inflammatory disease infiltrated by immunoglobulin IgG4-positive plasma cells. Typical images exhibit diffuse or partial pancreatic swelling with delayed enhancement and no obvious upstream duct dilation [2] . However, type 1 AIP occasionally appears in atypical clinical images and clinically mimics other pancreatic neoplasms (PN), such as pancreatic cancer (PC), intraductal papillary mucinous neoplasms (IPMN) and neuroendocrine neoplasm. It is very important for physicians or surgeons to distinguish between AIP and PN because the diagnosis greatly influences the selection of therapeutic schedule. AIP frequently responds rather readily to corticosteroid therapy while other PNs may need operations. Although the diagnostic criteria of AIP have been proposed [ 3 , 4 ], it still lacks practical strategies to differentiate between AIP and PN, particularly localized AIP. Confirmative pathological diagnosis is still the gold standard, but open biopsy is relatively invasive. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is less invasive and has a relatively high accuracy rate for distinguishing the essence of PN.
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| [1] |
Zhou L, Zhu JQ, Kou JT, Xu WL, Lyu SC, Du GS, Yang HW, Wang JF, Hu XP, Yu CZ, Yuan CH, Han DD, Sang CQ, Li B, Gao J, Qi HZ, Wang LM, Lyu L, Liu H, Wu JY, Lang R, He Q, Li XL. Chinese expert consensus on quantitatively monitoring and assessing immune cell function status and its clinical application (2024 edition)[J]. Hepatobiliary Pancreat Dis Int, 2024, 23(6): 551-558. |
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2024, Vol. 23 
