Source:http://linkedlifedata.com/resource/pubmed/id/20149413
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| Predicate | Object |
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| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
5
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| pubmed:dateCreated |
2010-4-19
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| pubmed:abstractText |
The patients with autoimmune pancreatitis usually present with jaundice and a pancreatic head mass, presumed to have pancreatic cancer, and they often undergo pancreatic resection. Elevated serum IgG4 levels (>135 mg/dL) help to distinguish autoimmune pancreatitis from pancreatic cancer. However, when the biopsy from a pancreatic mass shows dense chronic inflammation and fibrosis and the serum IgG4 level is not available, it presents a diagnostic dilemma whether it represents autoimmune pancreatitis or peritumoral pancreatitis. We performed IgG4 immunohistochemistry on 25 cases of autoimmune pancreatitis-lymphoplasmacytic sclerosing pancreatitis, 7 cases of autoimmune pancreatitis with granulocytic epithelial lesions, 8 cases of nonspecific pancreatitis, 15 cases of pancreatitis associated with pancreatic ductal adenocarcinoma, and 5 biopsies of pancreatic adenocarcinoma with variable inflammation. The distribution of IgG4-positive cells was noted in each case. Eighty-four percent (21/25) of autoimmune pancreatitis-LPSP cases showed diffuse and dense staining for IgG4, with more than 50 positive plasma cells per high-power field (range, 50-150 cells/hpf) in the highest density area. Most (5/7) cases of autoimmune pancreatitis-granulocytic epithelial lesions were negative for IgG4. Thirty-nine percent of nonspecific pancreatitis and peritumoral pancreatitis cases stained positive for IgG4, but the distribution was focal and none of the cases showed more than 50 IgG4-positive cells/hpf in the highest density area of IgG4 staining. IgG4-positive cells in peritumoral pancreatitis and nonspecific pancreatitis cases were closely associated with malignant glands and areas of acute inflammation in some cases. Using a cutoff of 50 IgG4-positive cells/hpf, the sensitivity of IgG4 staining for classical autoimmune pancreatitis-LPSP versus other types of pancreatitis was 84%, the specificity was 100%, and the P value was significant (<.0001). Hence, we conclude that diffuse and dense staining (>50 positive cells/hpf) for IgG4 is specifically seen in autoimmune pancreatitis-LPSP, and IgG4 staining along with the histologic features and serum IgG4 levels may be very helpful in diagnosing autoimmune pancreatitis.
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| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:chemical | |
| pubmed:status |
MEDLINE
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| pubmed:month |
May
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| pubmed:issn |
1532-8392
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| pubmed:author | |
| pubmed:copyrightInfo |
Copyright 2010 Elsevier Inc. All rights reserved.
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| pubmed:issnType |
Electronic
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| pubmed:volume |
41
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
643-52
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| pubmed:meshHeading |
pubmed-meshheading:20149413-Adolescent,
pubmed-meshheading:20149413-Adult,
pubmed-meshheading:20149413-Aged,
pubmed-meshheading:20149413-Aged, 80 and over,
pubmed-meshheading:20149413-Antigens, CD,
pubmed-meshheading:20149413-Autoimmune Diseases,
pubmed-meshheading:20149413-Carcinoma, Pancreatic Ductal,
pubmed-meshheading:20149413-Diagnosis, Differential,
pubmed-meshheading:20149413-Female,
pubmed-meshheading:20149413-Humans,
pubmed-meshheading:20149413-Immunoglobulin G,
pubmed-meshheading:20149413-Immunohistochemistry,
pubmed-meshheading:20149413-Male,
pubmed-meshheading:20149413-Middle Aged,
pubmed-meshheading:20149413-Pancreas,
pubmed-meshheading:20149413-Pancreatic Neoplasms,
pubmed-meshheading:20149413-Pancreatitis,
pubmed-meshheading:20149413-Plasma Cells
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| pubmed:year |
2010
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| pubmed:articleTitle |
Use of immunohistochemistry for IgG4 in the distinction of autoimmune pancreatitis from peritumoral pancreatitis.
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| pubmed:affiliation |
Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
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| pubmed:publicationType |
Journal Article
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