Autoimmune pancreatitis (AIP) type 1 and type 2

An international consensus study on histopathologic diagnostic criteria

Lizhi Zhang, Suresh T Chari, Thomas Christopher Smyrk, Vikram Deshpande, Günter Klöppel, Motohiro Kojima, Xiuli Liu, Daniel S. Longnecker, Mari Mino-Kenudson, Kenji Notohara, Manuel Rodriguez-Justo, Amitabh Srivastava, Giuseppe Zamboni, Yoh Zen

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Objectives: To develop and validate histologic diagnostic criteria for autoimmune pancreatitis (AIP) and its types. Methods: Thirteen pathologists participated in this 2-phase study to develop diagnostic criteria for AIP types 1 and 2 (phase 1) and validate them (phase 2). A virtual library of 40 resected pancreata with AIP and other forms of chronic pancreatitis (CP) was constructed. Readers reviewed the slides online and filled out a questionnaire for histopathologic findings and diagnosis. Results: Diagnostic criteria for AIP and its types were proposed according to the results from the top 5 reviewers in phase 1. The interobserver agreement was significantly improved in phase 2 by applying the proposed diagnostic criteria. Features distinguishing AIP from alcoholic and obstructive forms of CP were periductal lymphoplasmacytic infiltrate, inflamed cellular stroma with storiform fibrosis, obliterative phlebitis, and granulocytic epithelial lesions. Although there was overlap, 2 types of AIP were recognized. Type 1 had dense lymphoplasmacytic infiltrate with storiform fibrosis and obliterative phlebitis, whereas type 2 was distinguished from type 1 by the presence of granulocytic epithelial lesions. Conclusions: Autoimmune pancreatitis can be distinguished from other forms of CP with substantial interobserver agreement. The 2 types of AIP can be distinguished by the proposed consensus histopathologic diagnostic criteria.

Original languageEnglish (US)
Pages (from-to)1172-1179
Number of pages8
JournalPancreas
Volume40
Issue number8
DOIs
StatePublished - Nov 2011

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Pancreatitis
Chronic Pancreatitis
Phlebitis
Fibrosis
Alcoholic Pancreatitis
Digital Libraries
Pancreas

Keywords

  • autoimmune pancreatitis
  • chronic pancreatitis
  • granulocytic epithelial lesion
  • IgG4

ASJC Scopus subject areas

  • Hepatology
  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Autoimmune pancreatitis (AIP) type 1 and type 2 : An international consensus study on histopathologic diagnostic criteria. / Zhang, Lizhi; Chari, Suresh T; Smyrk, Thomas Christopher; Deshpande, Vikram; Klöppel, Günter; Kojima, Motohiro; Liu, Xiuli; Longnecker, Daniel S.; Mino-Kenudson, Mari; Notohara, Kenji; Rodriguez-Justo, Manuel; Srivastava, Amitabh; Zamboni, Giuseppe; Zen, Yoh.

In: Pancreas, Vol. 40, No. 8, 11.2011, p. 1172-1179.

Research output: Contribution to journalArticle

Zhang, L, Chari, ST, Smyrk, TC, Deshpande, V, Klöppel, G, Kojima, M, Liu, X, Longnecker, DS, Mino-Kenudson, M, Notohara, K, Rodriguez-Justo, M, Srivastava, A, Zamboni, G & Zen, Y 2011, 'Autoimmune pancreatitis (AIP) type 1 and type 2: An international consensus study on histopathologic diagnostic criteria', Pancreas, vol. 40, no. 8, pp. 1172-1179. https://doi.org/10.1097/MPA.0b013e318233bec5
Zhang, Lizhi ; Chari, Suresh T ; Smyrk, Thomas Christopher ; Deshpande, Vikram ; Klöppel, Günter ; Kojima, Motohiro ; Liu, Xiuli ; Longnecker, Daniel S. ; Mino-Kenudson, Mari ; Notohara, Kenji ; Rodriguez-Justo, Manuel ; Srivastava, Amitabh ; Zamboni, Giuseppe ; Zen, Yoh. / Autoimmune pancreatitis (AIP) type 1 and type 2 : An international consensus study on histopathologic diagnostic criteria. In: Pancreas. 2011 ; Vol. 40, No. 8. pp. 1172-1179.
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