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Overview :
Certain histopathologic features may be found in a patient
with autoimmune pancreatitis. These findings are not diagnostic but can be
supportive for the diagnosis.
Factors affecting interpretation:
(1) duration of disease (fibrosis increases with chronic
disease)
(2) corticosteroid or immunosuppressive therapy (reduce
inflammation)
Inflammatory findings:
(1) diffuse lymphoplasmacytic inflammation, which may be mild
to marked in intensity
(2) periductal inflammation
(3) perineural inflammation
(4) venulitis and obstructive phlebitis
Scarring:
(1) diffuse fibrosis
(2) acinar atrophy
Variable findings:
(1)
inflammatory pseudotumor (dense proliferation of spindle and chronic
inflammatory with collagen)
(2) periductal granulomas without pathogens
Relative exclusions:
(1) evidence of benign or malignant neoplasm
(2) organisms seen in periductal granulomas
(3) other
cause that can explain the findings better (tumor at the ampulla with
obstruction, etc.)
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