Ueno Kenji, Watanabe Tomohiro, Kawata Yukiko, Gotoh Tomoyuki, Tsuji Yoshihisa, Ida Hiroshi, Tada Shinsuke, Yazumi Shujiro, Chiba Tsutomu
Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Eur J Gastroenterol Hepatol. 2008 Nov;20(11):1118-21. doi: 10.1097/MEG.0b013e3282f82970.
We report a case of autoimmune pancreatitis involving the colonic mucosa. Although serum level of IgG4 was normal, computed tomography and endoscopic retrograde cholangiopancreatography showed diffuse enlargement of the pancreas and irregular narrowing of the pancreatic ducts, respectively. Colonoscopy revealed a polypoidal lesion in the ascending colon. A lymphoplasmacytic infiltration was seen both in the pancreas and in the polypoidal lesion of the colon. Furthermore, immunohistochemical analysis showed abundant IgG4-positive plasma cells in these lesions. This is the first case report of a simultaneous occurrence of autoimmune pancreatitis and a colonic polypoidal lesion, both of which are characterized with increased IgG4 responses.
我们报告一例累及结肠黏膜的自身免疫性胰腺炎病例。尽管血清IgG4水平正常,但计算机断层扫描和内镜逆行胰胆管造影分别显示胰腺弥漫性肿大和胰管不规则狭窄。结肠镜检查发现升结肠有息肉样病变。在胰腺和结肠息肉样病变中均可见淋巴细胞和浆细胞浸润。此外,免疫组化分析显示这些病变中有大量IgG4阳性浆细胞。这是首例同时发生自身免疫性胰腺炎和结肠息肉样病变的病例报告,二者均以IgG4反应增加为特征。