Simultaneous occurrence of autoimmune pancreatitis and pancreatic cancer in patients resected for focal pancreatic mass

Table 1 Characteristics of patients with autoimmune pancreatitis and autoimmune pancreatitis + pancreatic cancer n (%)

	AIP without PC	AIP with PC	P value
Total	9 (60)	6 (40)
AIP type 1	4 (44)	2 (33)
AIP type 2	5 (56)	4 (67)
Sex (males)	6 (67)	6 (100)
Age	49 (35-64)	60.5 (54-67)	0.045
Smoking	5 (56)	4 (67)
Recent onset of diabetes mellitus	1 (11)	4 (67)	0.090
History of another autoimmune disorder	4 (44)1	0
History of pancreatic disease	5 (56)2	1 (17)3
Jaundice	3 (33)	4 (67)
Weight loss	6 (67)	6 (100)
in kilograms	8.5 (3-12)	15.5 (8-50)	0.030
Location of lesion (head of the pancreas)	8 (89)	5 (83)
Ca 19-9 (normal range 0-27 kU/L)	35.2 (2.5-300)	89.8 (19.8-110)

¹1 × IgG4-related sclerosing cholangitis, 1 × IgG4-related sialadenitis, 1 × Crohn's disease, 1 × Autoimmune thyroiditis;

²2 × Chronic pancreatitis, 3 × Acute pancreatitis;

³1 × Chronic pancreatitis. Quantitative data are expressed as median (range), qualitative data as absolute values with percentages. AIP: Autoimmune pancreatitis; PC: Pancreatic cancer.

Table 2 Histopathology findings in patients with type 1 autoimmune pancreatitis + pancreatic cancer

Patient	Sex	Age	Periductal lymphoplasmacytic infiltrate without granulocytic infiltration	Obliterative phlebitis	Storiform fibrosis	IgG4-positive cells
2	M	67	Yes	Yes	Yes	47/HPF
6	M	61	Yes	Yes	Yes	58/HPF

HPF: High-power field.

Table 3 Histopathology findings in patients with type 2 autoimmune pancreatitis + pancreatic cancer

Patient	Sex	Age	Granulocytic infiltration of duct wall (GEL)	Granulocytic and lymphoplasmacytic acinar infiltrate	IgG4-positive cells
1	M	54	Yes		4/HPF
3	M	63	Yes		2/HPF
4	M	58	Yes		7/HPF
5	M	60	Yes		4/HPF

HPF: High-power field.

Table 4 Serum IgG4, imaging methods and fine needle aspiration biopsy results in patients with autoimmune pancreatitis and autoimmune pancreatitis + pancreatic cancer

	Sex	Age	Serum IgG4 (mg/dL)	CT	ERP	EUS	EUS-FNA
AIP type 1 + PC	M	67	N/A	A	N/A	N/A	N/A
	M	61	N/A	A	CBD stricture; no wirsungography	Susp M	Inconclusive
AIP type 1	M	46	81.5	L2	CBD stricture; no wirsungography	Ambigious	Negative
	M	57	81.5	A	CBD stricture; no wirsungography	N/A	N/A
	M	49	N/A	A	Unsuccesful attempt for wirsungography	Cystic tumour; signs of CHP	Inconclusive
	M	48	23.1	L2	N/A	Susp M	Negative
AIP type 2 + PC	M	54	NR	L2	N/A	Ambigious	Susp M
	M	63	NR	A	N/A	Ambigious	Susp M
	M	58	NR	A	Wirsungolithiasis	N/A	N/A
	M	60	NR	A	N/A	Ambigious	Susp M
AIP type 2	F	61	NR	L2	N/A	Susp M	Susp M
	F	64	NR	A	Dilated PD; mucous secretion	Susp MD-IPMN	Negative
	M	35	NR	L2	N/A	ambigious	Susp M
	F	47	NR	L2	N/A	ambigious	Negative
	M	53	NR	A	N/A	N/A	N/A

L2: Level 2 evidence of parenchymal imaging according to ICDC criteria; M: Male; F: Female; NR: Not relevant; N/A: Results not available or examination not done; A: Atypical-finding not suggestive of AIP; susp M: Findings suspected of malignancy; CHP: Chronic pancreatitis; CBD: Common bile duct; PD: Pancreatic duct; EUS: Endoscopic ultrasonography; EUS-FNA: Endoscopic ultrasound-guided fine needle aspiration biopsy; CT: Computed tomography; AIP: Autoimmune pancreatitis; PC: Pancreatic cancer.