Departmental Bulletin Paper Endosonographic features of autoimmune pancreatitis

窪田, 賢輔

67 ( 1 )  , pp.53 - 58 , 2016-01-31 , 横浜市立大学医学会
Autoimmune pancreatitis (AIP) has come to be increasingly recognized due to the evolving awareness about the disease and the possibility of making a correct diagnosis based on consensus diagnostic criteria. Diagnosis of AIP is no longer difficult, because of the existence of reliable international consensus guidelines. AIP is visualized as a diffuse swelling of the pancreas with a capsular rim on computed tomography, although it sometimes manifests as a focal mass lesion mimicking pancreatic cancer. Endoscopic ultrasonography (EUS) could play pivotal role in the diagnosis of AIP in that it can provide real-time imaging findings of early chronic pancreatitis, including features such as foci/stranding, lobularity and a hyperechoic pancreatic duct margin, and also features of advanced pancreatitis such as cyst formation, dilatation of the side branches of the pancreatic duct and calcification. EUS-guided fine-needle aspiration biopsy( EUS-FNA) also allows tissue specimens to be obtained, which could be processed for histopathology and immunohistochemistry for the diagnosis of type ₂ AIP. EUS-elastography and contrast-enhanced EUS are also promising techniques.

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