Fine needle aspirate of autoimmune pancreatitis (lymphoplasmacytic sclerosing pancreatitis): cytomorphologic characteristics and clinical correlates

Acta Cytologica
Brittany J HolmesSyed Z Ali

Abstract

Autoimmune pancreatitis (AIP) is an inflammatory, IgG4-associated condition that often overlaps clinically and radiographically with pancreatic ductal adenocarcinoma. We reviewed our institutional experience with fine needle aspiration (FNA) cytology in patients subsequently diagnosed with AIP. A retrospective review was conducted of FNA results correlating to all surgical pancreatic specimens diagnosed as AIP or lymphoplasmacytic sclerosing pancreatitis from 1984 to 2011. AIP was diagnosed in 15 cases by surgical resection and in 2 by combined clinical findings and nondiagnostic biopsies. Of 20 aspirates from 17 patients, 1 was diagnosed as malignant, 1 as neoplasm (mucinous), 10 as atypical, 5 as benign, and 3 as scant or nondiagnostic. Of the 10 aspirates diagnosed as atypical, 1 was suspicious for malignancy, 1 could not exclude neuroendocrine neoplasm, 1 was markedly atypical, and 7 demonstrated scattered ductal atypia. Common morphologic features included hypocellularity, focal-to-marked ductal epithelial atypia, fibrous tissue fragments, and a smear background lacking red blood cells. On FNA, AIP most often leads to an 'atypical' cytopathologic interpretation and rarely may be diagnosed as adenocarcinoma. Thus, caution i...Continue Reading

Citations

Jun 21, 2014·Endoscopic Ultrasound·Pierre Eisendrath, Mostafa Ibrahim
May 29, 2013·Cytopathology : Official Journal of the British Society for Clinical Cytology·R DinaD Spalding
Apr 3, 2020·La Presse médicale·Vinciane Rebours, Philippe Lévy

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