By Terumi Kamisawa, Jae Bock Chung
This e-book presents updated details on all facets of autoimmune pancreatitis, a distinct kind of pancreatitis characterised clinically through widespread presentation with obstructive jaundice and dramatic reaction to steroids, histologically by way of a lymphoplasmacytic infiltrate with fibrosis, and radiologically by means of pancreatic growth. present recommendations in regards to the ailment and its category into subtypes 1 and a couple of are defined, and scientific, serological, and histopathological findings are rigorously defined. Imaging good points on the entire suitable modalities are illustrated, overlaying either the pancreas and different concerned organs. present and rising healing ideas, together with steroids, immunomodulatory medicines, and rituximab, are then mentioned. The reader will locate the e-book to be a great reduction to the prognosis of autoimmune pancreatitis and its differentiation from pancreatobiliary malignancies, in addition to a transparent consultant to treatment.
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Extra info for Autoimmune Pancreatitis
Pancreas. 2010;39(5):549–54. Zhang L, Chari S, Smyrk TC, Deshpande V, Kloppel G, Kojima M, Liu X, Longnecker DS, Mino-Kenudson M, Notohara K, RodriguezJusto M, Srivastava A, Zamboni G, Zen Y. Autoimmune pancreatitis (AIP) type 1 and type 2: an international consensus study on histopathologic diagnostic criteria. Pancreas. 2011;40(8):1172–9. Zen Y, Harada K, Sasaki M, Sato Y, Tsuneyama K, Haratake J, Kurumaya H, Katayanagi K, Masuda S, Niwa H, Morimoto H, Miwa A, Uchiyama A, Portmann BC, Nakanuma Y.
The discovery of elevated serum IgG4 in patients with AIP by Hamano and colleagues motivated further research into AIP , and LPSP is now regarded as the pancreatic manifestation of IgG4-related disease (IgG4-RD) in the present consensus [8–10]. In addition, the subclassification of AIP was proposed based on its different demographics and clinical features [11– 13], and LPSP and IDCP were designated as type 1 and type 2 AIP, respectively . In fact, the histological features of type 1 and type 2 AIP are distinct, and pathologists can distinguish them with hematoxylin and eosin (HE) stain alone without the aid of IgG4 immunostaining, which was validated by an international interobserver study .
This will be described in detail in a later section. Pancreatic Parenchymal Inﬂammation The pancreatic parenchymal inflammation can be seen in the pancreatic ducts and lobules. T. B. 1007/978-3-642-55086-7_4, © Springer-Verlag Berlin Heidelberg 2015 23 24 K. Notohara a b c d e f Fig. 1 Histological features of type 1 AIP. (a, b) The cell-rich form (a) and transitional form between the cell-rich and fibrotic states (b) of storiform fibrosis. (c) Ductal inflammation. A thick inflammatory collar with storiform fibrosis surrounds the intact duct epithelium.