Chulalongkorn Medical Journal


Background : Autoimmune pancreatitis (AIP) is a rare disease, describes aform of chronic pancreatitis with associated autoimmunemechanism and difficulties in diagnosis. Focal AIP may mimicpancreatic cancer.Objective : The purpose of this study was to determine the possible CTfindings of the patients with AIP.Design : Retrospective descriptive study.Setting : King Chulalongkorn Memorial Hospital.Materials and Methods : Retrospectively review of clinical presentations, laboratory dataand CT findings with pancreatic protocol of 8 patients who werediagnosed with AIP between January 1st, 2000 and May 31st,2012.Results : All patients presented with jaundice and elevated serum IgG4level. CT findings: diffuse (1of 8 patients, 12.5%) or focal (4 of8 patients, 50%) pancreatic enlargement, normal pancreaticparenchymal enhancement (1 of 8 patients, 12.5%), abnormalpancreatic parenchymal enhancement (7 of 8 patients, 87.5%),normal pancreas (3 of 8 patients, 37.5%), loss of normalpancreatic lobularity (3 of 8 patients, 37.5%), peripancreatic fatstranding (1 of 8 patients, 12.5%), positive “halo sign” (2 of8 patients, 25%), diffuse pancreatic duct dilatation (2 of 8 patients,25%), diffuse CBD dilatation with wall enhancement andthickening (2 of 8 patients, 25%), normal CBD with intrapancreaticbile duct dilatation with wall enhancement and thickening (1of8 patients, 12.5%), diffuse CBD dilatation with stent insertion(3 of 8 patients, 37.5%), diffuse duct dilatation (1of 8 patients,12.5%), normal CBD (1of 8 patients, 12.5%).Conclusion : CT findings of AIP showed classic appearances of diffusepancreatic enlargement with loss of normal pancreatic lobularity,peripancreatic fat standing, and positive “halo” sign withpancreatic or CBD dilatation, or focal pancreatic enlargement.However, normal CT imaging of pancreasis one characteristicon CT imaging.


Faculty of Medicine, Chulalongkorn University

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