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dc.contributor.authorSepehr, Alireza
dc.contributor.authorMino-Kenudson, Mari
dc.contributor.authorOgawa, Fumihiro
dc.contributor.authorBrugge, William Robert
dc.contributor.authorDeshpande, Vikram
dc.contributor.authorLauwers, Gregory Y.
dc.date.accessioned2018-03-26T18:57:09Z
dc.date.issued2008
dc.identifier.citationSepehr, Alireza, Mari Mino-Kenudson, Fumihiro Ogawa, William R. Brugge, Vikram Deshpande, and Gregory Y. Lauwers. 2008. “IgG4+ to IgG+ Plasma Cells Ratio of Ampulla Can Help Differentiate Autoimmune Pancreatitis From Other ‘Mass Forming’ Pancreatic Lesions.” The American Journal of Surgical Pathology 32 (12) (December): 1770–1779. doi:10.1097/pas.0b013e318185490a.en_US
dc.identifier.issn0147-5185en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:35136075
dc.description.abstractAutoimmune pancreatitis (AIP) shows a unique spectrum of histologic features and commonly presents with an abundant IgG4-positive (IgG4+) plasma cell infiltration. However, differentiating AIP from other mass lesions, particularly pancreatic cancer [invasive ductal carcinoma (IDC)] can be clinically challenging. In this study, we evaluated the validity of IgG4 and IgG immunohistochemistry of ampullary and periampullary tissue for the diagnosis of AIP. Our study group consisted of 14 resected AIP cases with appropriate ampullary sections. Superficial ampullary tissue and "shouldering" duodenal mucosa were evaluated for several histologic variables. Immunohistochemistry for IgG4 and IgG was performed. The number of IgG4 and IgG-positive plasma cells was counted and an IgG4+ to IgG+ plasma cells ratio (IgG4/IgG ratio) was evaluated. A control cohort was composed of IDC (n=30) and chronic pancreatitis (CP) (n=29). Although an overlap was present between the groups, the overall inflammation and number of plasma cells in and around the ampulla was significantly increased in AIP compared with CP and IDC. Furthermore, although there was some overlap in the crude number of IgG4+ plasma cells of the ampullary and duodenal tissue between AIP, IDC, and CP, an IgG4/IgG ratio, especially of the ampulla, seems diagnostically useful in differentiating AIP from other "mass forming" lesions. When a cut-off of 0.10 was applied, the diagnostic sensitivity and specificity of the ampullary IgG4/IgG ratio was 86% and 95%, respectively. In conclusion, evaluation of ampullary histology and IgG4/IgG ratio might be proven beneficial in discriminating AIP from other mass forming pancreatic lesions.en_US
dc.language.isoen_USen_US
dc.publisherOvid Technologies (Wolters Kluwer Health)en_US
dc.relation.isversionofdoi:10.1097/PAS.0b013e318185490aen_US
dash.licenseMETA_ONLY
dc.subjectautoimmune pancreatitisen_US
dc.subjectmajor ampullaen_US
dc.subjectendoscopyen_US
dc.subjectIgG4en_US
dc.subjectIgG4/IgG ratioen_US
dc.titleIgG4+ to IgG+ Plasma Cells Ratio of Ampulla Can Help Differentiate Autoimmune Pancreatitis From Other “Mass Forming” Pancreatic Lesionsen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalThe American Journal of Surgical Pathologyen_US
dash.depositing.authorLauwers, Gregory Y.
dash.embargo.until10000-01-01
dc.identifier.doi10.1097/PAS.0b013e318185490a*
dash.contributor.affiliatedSepehr, Alireza
dash.contributor.affiliatedBrugge, William
dash.contributor.affiliatedLauwers, Gregory Y.
dash.contributor.affiliatedDeshpande, Vikram
dash.contributor.affiliatedMino-Kenudson, Mari
dc.identifier.orcid0000-0003-4230-9308


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