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Difficulty in diagnosing autoimmune pancreatitis by imaging findings
Takahiro Nakazawa1, Hirotaka Ohara, Hitoshi Sano
1Department of Internal Medicine and Bioregulation, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Gastrointestinal Endoscopy
|December 23, 2006
Summary
Autoimmune pancreatitis (AIP) shows diverse imaging findings, often leading to misdiagnosis. Increased clinician awareness of AIP and its varied presentations is crucial for accurate diagnosis.
Area of Science:
- Gastroenterology and Hepatology
- Radiology and Medical Imaging
- Immunology
Background:
- Autoimmune pancreatitis (AIP) is characterized by pancreatic enlargement and main pancreatic duct narrowing.
- Atypical imaging findings in AIP cases pose diagnostic challenges.
Purpose of the Study:
- To elucidate the spectrum of imaging findings in autoimmune pancreatitis (AIP).
- To identify reasons for misdiagnosis in AIP cases.
Main Methods:
- Retrospective analysis of imaging findings in 37 confirmed AIP cases.
- Review of misdiagnosed AIP cases to determine diagnostic errors.
- Study period: 1989 to May 2005.
Main Results:
- Only 7 out of 37 AIP cases presented with typical imaging findings.
- Atypical findings included segmental pancreatic duct stenosis (15 cases), focal enlargement (6 cases), calcifications (3 cases), and pancreatic cysts (2 cases).
- Misdiagnoses included pancreatic cancer (6 cases) and bile-duct cancer (2 cases), often due to unfamiliarity with AIP or atypical presentations.
Conclusions:
- Autoimmune pancreatitis exhibits a wide range of imaging manifestations.
- Clinician awareness of AIP's diverse imaging features and the concept of AIP itself is paramount for accurate diagnosis.
- Understanding atypical presentations can prevent misdiagnosis, particularly distinguishing AIP from pancreatic and bile-duct cancers.
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