138 - Autoimmune pancreatitis
Autor(s): L. Frulloni, C. Scattolini, I. Vantini
Issue: RIMeL - IJLaM, Vol. 4, N. 2, 2008 (MAF Servizi srl ed.)
Page(s): 138-143
Autoimmune pancreatitis is a newly described inflammatory disease histologically characterised by the presence of periductal inflammation, lymphoplasmacytic infiltration, periductal or storiform fibrosis and acinar atrophy, associated with vascular involvement and sometimes extrapancreatic involvement. IgG4 positive plasma cells may be also found by immunochemistry tests in pancreatic specimens. Autoimmune pancreatitis may be associated with other autoimmune diseases of the gastrointestinal tract, or with autoimmune systemic diseases. The clinical-morphological presentation could be both pancreatitis, with diffuse involvement of the gland, or pancreatic mass mimicking tumour. Fine needle aspiration biopsy or cytology is strongly suggested in focal forms to exclude cancer. The diagnosis of autoimmune pancreatitis could be a challenge to cytology or histology and requires expert pathologists. The disease responds quickly to steroid therapy and this may represent a criterion for the diagnosis. Steroids may imply the onset of diabetes that may need the use of insulin in the period treatment.