Abstract
Aim To study the prevalence and distribution of IgG4-positive plasma cells in pancreatic and ampullary carcinoma. Method 29 cases of primary pancreatic and ampullary carcinoma between 2008 and 2011 were retrieved from archive. IgG4 staining by immunohistochemistry was performed on sections of the tumour with surrounding pancreas and pancreatic ducts. The pattern of distribution and the mean numbers of IgG4-positive plasma cells were obtained. Results 19 of 29 (66%) cases showed the presence IgG4-positive plasma and eight cases (28%) featured >30 positive cells/HPF. Six cases (21%) showed a periductal distribution of IgG4 positive plasma cell with three cases (10%) displaying >10 positive cells/HPF. Two cases (7%) showed a diffuse distribution of IgG4-positive plasma cells. Conclusion IgG4-positive plasma cells are not infrequently found in association with pancreatic and ampullary adenocarcinoma. Our study highlights the presence of both peritumoural and periductal IgG4-positive plasma cells, which may rarely be diffusely distributed, in a significant minority of pancreatic and ampullary carcinomas. It is important that clinical, radiological and pathological correlation be used in the diagnosis of autoimmune pancreatitis as IgG4-positive cells may be seen in a proportion of carcinomas.
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