Abstract
Differential diagnosis of autoimmune pancreatitis apart from everything else is based on specifics of immunoglobulin G4 involvement into the pathogenesis.
 Aim is to analyze two forms of autoimmune pancreatitis and their relation to the level of IgG4-positive plasma cells.
 Methods and results. The present study was conducted on 54 patients with chronic pancreatitis, from which 15 cases with autoimmune pancreatitis were selected by using morphological and immunohistochemical methods.
 Conclusion. It has been established that for autoimmune pancreatitis type I dense lymphocytic periductal infiltrate, multilevel fibrosis, obliterating venulitis and high IgG4-positive plasma cells in the pancreas (>30 per high power field) were typical. In the cases of autoimmune pancreatitis type II, besides the specific histopathological signs of AIP, significantly epithelial damage of pancreatic ducts by leukocytes, low levels of IgG4-PPC in the pancreas and focal lesions on stages I–III of disease (80%) were observed.
Highlights
Для аутоиммунного панкреатита II типа, кроме типичных пагогистологическнх признаков аутоиммунного панкреатита, свойственно лейкоцитарное повреждение эпителия панкреатических протоков, низкий уровень IgG4-ППK в поджелудочной железе и очаговые поражения на I–III стадиях заболевания (80% случаев)
In the cases of autoimmune pancreatitis type II, besides the specific histopathological signs of AIP, significantly epithelial damage of pancreatic ducts by leuko cytes, low levels of IgG4-PPC in the pancreas and focal lesions on stages I–III of disease (80%) were observed
Summary
Цель работы — изучение особенностей гистопатологии ПЖ при АИП I и II типа в связи с уровнем IgG4-позитивных плазматических клеток в органе. В паренхиме ПЖ всех больных с АИП I типа в плотном лимфоплазмоцитарном инфильтрате вокруг магистральных и междольковых панкреатических протоков и лимфатических фолликулов отмечали компактные скопления IgG-ППК Что обнаружение трех характерных гистологических признаков в пораженной ПЖ позволяет отнести АИП I типа к IgG4-ассоциированным склерозирующим заболеваниям: плотный лимфоплазматический инфильтрат вокруг магистральных протоков ПЖ, многоярусный фиброз, облитерирующий флебит [1, 3].
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