Autoimmune pancreatitis and biliary intraepithelial neoplasia of the common bile duct: A case with diagnostically challenging but pathogenetically significant association
Autoimmune pancreatitis (AIP) (also called IgG4‐related sclerosing pancreatitis (IgG4‐SP)) and IgG4‐related sclerosing cholangitis (IgG4‐SC) are frequently associated with each other. It is generally believed that association of these diseases with pancreatobiliary malignancy is, however, rare. Here...
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| Veröffentlicht in: | Pathology international 2011-08, Vol.61 (8), p.481-485 |
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| creator | Ohtani, Haruo Ishida, Hiroyasu Ito, Yuka Yamaguchi, Takashi Koizumi, Masanori |
| description | Autoimmune pancreatitis (AIP) (also called IgG4‐related sclerosing pancreatitis (IgG4‐SP)) and IgG4‐related sclerosing cholangitis (IgG4‐SC) are frequently associated with each other. It is generally believed that association of these diseases with pancreatobiliary malignancy is, however, rare. Here, we report on the case of a patient with AIP whose biliary cytology revealed severely atypical cells. Surgically resected specimens from this patient showed typical AIP with IgG4‐SC, as well as a mildly elevated lesion in the common bile duct with varying degrees of cellular atypia. In addition, the atypical cells tested positive for the mucin‐core protein, MUC5AC and p53 overexpression. These findings led us to diagnose the common bile duct lesion as biliary intraepithelial neoplasia (BilIN, mainly BilIN‐1/2). Recently, associations between K‐ras mutations and pancreatobiliary carcinoma have been reported in patients with AIP. This case, therefore, provides important new insight into the potential association of AIP and/or IgG4‐SC with malignancy (or precursor lesions) of the pancreatobiliary system. |
| doi_str_mv | 10.1111/j.1440-1827.2011.02684.x |
| format | Article |
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It is generally believed that association of these diseases with pancreatobiliary malignancy is, however, rare. Here, we report on the case of a patient with AIP whose biliary cytology revealed severely atypical cells. Surgically resected specimens from this patient showed typical AIP with IgG4‐SC, as well as a mildly elevated lesion in the common bile duct with varying degrees of cellular atypia. In addition, the atypical cells tested positive for the mucin‐core protein, MUC5AC and p53 overexpression. These findings led us to diagnose the common bile duct lesion as biliary intraepithelial neoplasia (BilIN, mainly BilIN‐1/2). Recently, associations between K‐ras mutations and pancreatobiliary carcinoma have been reported in patients with AIP. This case, therefore, provides important new insight into the potential association of AIP and/or IgG4‐SC with malignancy (or precursor lesions) of the pancreatobiliary system.</description><identifier>ISSN: 1320-5463</identifier><identifier>EISSN: 1440-1827</identifier><identifier>DOI: 10.1111/j.1440-1827.2011.02684.x</identifier><identifier>PMID: 21790863</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>Adenocarcinoma - complications ; Adenocarcinoma - diagnosis ; Adenocarcinoma - metabolism ; Autoimmune Diseases - complications ; Autoimmune Diseases - diagnosis ; Autoimmune Diseases - metabolism ; autoimmune pancreatitis ; biliary intraepithelial neoplasia ; Biomarkers, Tumor - metabolism ; Cholangitis, Sclerosing - complications ; Cholangitis, Sclerosing - diagnosis ; Cholangitis, Sclerosing - metabolism ; Common Bile Duct - metabolism ; Common Bile Duct - pathology ; Common Bile Duct - surgery ; Common Bile Duct Neoplasms - complications ; Common Bile Duct Neoplasms - diagnosis ; Common Bile Duct Neoplasms - metabolism ; Humans ; IgG4‐related sclerosing cholangitis ; Immunoglobulin G - blood ; Male ; Middle Aged ; Mucin 5AC - metabolism ; Tomography, X-Ray Computed ; Tumor Suppressor Protein p53 - metabolism</subject><ispartof>Pathology international, 2011-08, Vol.61 (8), p.481-485</ispartof><rights>2011 The Authors. Pathology International © 2011 Japanese Society of Pathology and Blackwell Publishing Asia Pty Ltd</rights><rights>2011 The Authors. Pathology International © 2011 Japanese Society of Pathology and Blackwell Publishing Asia Pty Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4544-cb9b3a3fe63e8bf892f141ace489779ad2f1950300cbcdac84e5f8e78f6f827c3</citedby><cites>FETCH-LOGICAL-c4544-cb9b3a3fe63e8bf892f141ace489779ad2f1950300cbcdac84e5f8e78f6f827c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1440-1827.2011.02684.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1440-1827.2011.02684.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21790863$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ohtani, Haruo</creatorcontrib><creatorcontrib>Ishida, Hiroyasu</creatorcontrib><creatorcontrib>Ito, Yuka</creatorcontrib><creatorcontrib>Yamaguchi, Takashi</creatorcontrib><creatorcontrib>Koizumi, Masanori</creatorcontrib><title>Autoimmune pancreatitis and biliary intraepithelial neoplasia of the common bile duct: A case with diagnostically challenging but pathogenetically significant association</title><title>Pathology international</title><addtitle>Pathol Int</addtitle><description>Autoimmune pancreatitis (AIP) (also called IgG4‐related sclerosing pancreatitis (IgG4‐SP)) and IgG4‐related sclerosing cholangitis (IgG4‐SC) are frequently associated with each other. It is generally believed that association of these diseases with pancreatobiliary malignancy is, however, rare. Here, we report on the case of a patient with AIP whose biliary cytology revealed severely atypical cells. Surgically resected specimens from this patient showed typical AIP with IgG4‐SC, as well as a mildly elevated lesion in the common bile duct with varying degrees of cellular atypia. In addition, the atypical cells tested positive for the mucin‐core protein, MUC5AC and p53 overexpression. These findings led us to diagnose the common bile duct lesion as biliary intraepithelial neoplasia (BilIN, mainly BilIN‐1/2). Recently, associations between K‐ras mutations and pancreatobiliary carcinoma have been reported in patients with AIP. This case, therefore, provides important new insight into the potential association of AIP and/or IgG4‐SC with malignancy (or precursor lesions) of the pancreatobiliary system.</description><subject>Adenocarcinoma - complications</subject><subject>Adenocarcinoma - diagnosis</subject><subject>Adenocarcinoma - metabolism</subject><subject>Autoimmune Diseases - complications</subject><subject>Autoimmune Diseases - diagnosis</subject><subject>Autoimmune Diseases - metabolism</subject><subject>autoimmune pancreatitis</subject><subject>biliary intraepithelial neoplasia</subject><subject>Biomarkers, Tumor - metabolism</subject><subject>Cholangitis, Sclerosing - complications</subject><subject>Cholangitis, Sclerosing - diagnosis</subject><subject>Cholangitis, Sclerosing - metabolism</subject><subject>Common Bile Duct - metabolism</subject><subject>Common Bile Duct - pathology</subject><subject>Common Bile Duct - surgery</subject><subject>Common Bile Duct Neoplasms - complications</subject><subject>Common Bile Duct Neoplasms - diagnosis</subject><subject>Common Bile Duct Neoplasms - metabolism</subject><subject>Humans</subject><subject>IgG4‐related sclerosing cholangitis</subject><subject>Immunoglobulin G - blood</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mucin 5AC - metabolism</subject><subject>Tomography, X-Ray Computed</subject><subject>Tumor Suppressor Protein p53 - metabolism</subject><issn>1320-5463</issn><issn>1440-1827</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1u1DAQxyMEoqXwCsg3uCS1Yye2kTisKqCVKuAAZ8txxlmvEjvEjtp9JZ4Sh217RPgyH_7NjD3_okAEVySfy0NFGMMlETWvakxIhetWsOr-WXH-dPE8-7TGZcNaela8ivGAMeG0xS-Ls5pwiUVLz4vfuzUFN02rBzRrbxbQySUXkfY96tzo9HJEzqdFw-zSHnJiRB7CPOroNAoW5SQyYZqC33hA_WrSB7RDRkdAd7kG9U4PPsTkjB7HIzL7bMAPzg-oW1Mem_ZhAA-PQHSDdzYHPiEdYzAuvyn418ULq8cIbx7sRfHz86cfV9fl7bcvN1e729KwhrHSdLKjmlpoKYjOCllbwog2wITkXOo-x7LBFGPTmV4bwaCxAriwrc1rM_SieHfqOy_h1woxqclFA-Oo87_XqASXLRdYkky-_ydJWMsa3HImMypOqFlCjAtYNS9uystVBKtNU3VQm3Rqk05tmqq_mqr7XPr2YcraTdA_FT6KmIGPJ-Au7__4343V95uvm0f_ALH6tUQ</recordid><startdate>201108</startdate><enddate>201108</enddate><creator>Ohtani, Haruo</creator><creator>Ishida, Hiroyasu</creator><creator>Ito, Yuka</creator><creator>Yamaguchi, Takashi</creator><creator>Koizumi, Masanori</creator><general>Blackwell Publishing Asia</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>201108</creationdate><title>Autoimmune pancreatitis and biliary intraepithelial neoplasia of the common bile duct: A case with diagnostically challenging but pathogenetically significant association</title><author>Ohtani, Haruo ; Ishida, Hiroyasu ; Ito, Yuka ; Yamaguchi, Takashi ; Koizumi, Masanori</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4544-cb9b3a3fe63e8bf892f141ace489779ad2f1950300cbcdac84e5f8e78f6f827c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adenocarcinoma - complications</topic><topic>Adenocarcinoma - diagnosis</topic><topic>Adenocarcinoma - metabolism</topic><topic>Autoimmune Diseases - complications</topic><topic>Autoimmune Diseases - diagnosis</topic><topic>Autoimmune Diseases - metabolism</topic><topic>autoimmune pancreatitis</topic><topic>biliary intraepithelial neoplasia</topic><topic>Biomarkers, Tumor - metabolism</topic><topic>Cholangitis, Sclerosing - complications</topic><topic>Cholangitis, Sclerosing - diagnosis</topic><topic>Cholangitis, Sclerosing - metabolism</topic><topic>Common Bile Duct - metabolism</topic><topic>Common Bile Duct - pathology</topic><topic>Common Bile Duct - surgery</topic><topic>Common Bile Duct Neoplasms - complications</topic><topic>Common Bile Duct Neoplasms - diagnosis</topic><topic>Common Bile Duct Neoplasms - metabolism</topic><topic>Humans</topic><topic>IgG4‐related sclerosing cholangitis</topic><topic>Immunoglobulin G - blood</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mucin 5AC - metabolism</topic><topic>Tomography, X-Ray Computed</topic><topic>Tumor Suppressor Protein p53 - metabolism</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ohtani, Haruo</creatorcontrib><creatorcontrib>Ishida, Hiroyasu</creatorcontrib><creatorcontrib>Ito, Yuka</creatorcontrib><creatorcontrib>Yamaguchi, Takashi</creatorcontrib><creatorcontrib>Koizumi, Masanori</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Pathology international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ohtani, Haruo</au><au>Ishida, Hiroyasu</au><au>Ito, Yuka</au><au>Yamaguchi, Takashi</au><au>Koizumi, Masanori</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Autoimmune pancreatitis and biliary intraepithelial neoplasia of the common bile duct: A case with diagnostically challenging but pathogenetically significant association</atitle><jtitle>Pathology international</jtitle><addtitle>Pathol Int</addtitle><date>2011-08</date><risdate>2011</risdate><volume>61</volume><issue>8</issue><spage>481</spage><epage>485</epage><pages>481-485</pages><issn>1320-5463</issn><eissn>1440-1827</eissn><abstract>Autoimmune pancreatitis (AIP) (also called IgG4‐related sclerosing pancreatitis (IgG4‐SP)) and IgG4‐related sclerosing cholangitis (IgG4‐SC) are frequently associated with each other. It is generally believed that association of these diseases with pancreatobiliary malignancy is, however, rare. Here, we report on the case of a patient with AIP whose biliary cytology revealed severely atypical cells. Surgically resected specimens from this patient showed typical AIP with IgG4‐SC, as well as a mildly elevated lesion in the common bile duct with varying degrees of cellular atypia. In addition, the atypical cells tested positive for the mucin‐core protein, MUC5AC and p53 overexpression. These findings led us to diagnose the common bile duct lesion as biliary intraepithelial neoplasia (BilIN, mainly BilIN‐1/2). Recently, associations between K‐ras mutations and pancreatobiliary carcinoma have been reported in patients with AIP. This case, therefore, provides important new insight into the potential association of AIP and/or IgG4‐SC with malignancy (or precursor lesions) of the pancreatobiliary system.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>21790863</pmid><doi>10.1111/j.1440-1827.2011.02684.x</doi><tpages>5</tpages></addata></record> |
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| subjects | Adenocarcinoma - complications Adenocarcinoma - diagnosis Adenocarcinoma - metabolism Autoimmune Diseases - complications Autoimmune Diseases - diagnosis Autoimmune Diseases - metabolism autoimmune pancreatitis biliary intraepithelial neoplasia Biomarkers, Tumor - metabolism Cholangitis, Sclerosing - complications Cholangitis, Sclerosing - diagnosis Cholangitis, Sclerosing - metabolism Common Bile Duct - metabolism Common Bile Duct - pathology Common Bile Duct - surgery Common Bile Duct Neoplasms - complications Common Bile Duct Neoplasms - diagnosis Common Bile Duct Neoplasms - metabolism Humans IgG4‐related sclerosing cholangitis Immunoglobulin G - blood Male Middle Aged Mucin 5AC - metabolism Tomography, X-Ray Computed Tumor Suppressor Protein p53 - metabolism |
| title | Autoimmune pancreatitis and biliary intraepithelial neoplasia of the common bile duct: A case with diagnostically challenging but pathogenetically significant association |
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