{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T01:37:54Z","timestamp":1785289074230,"version":"3.55.0"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:00:00Z","timestamp":1551225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:00:00Z","timestamp":1551225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2019,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Autoimmune pancreatitis (AIP) is an uncommon form of chronic pancreatitis. Whilst being corticosteroid responsive, AIP often masquerades radiologically as pancreatic neoplasia. Our aim is to appraise demographic, radiological and histological features in our cohort in order to differentiate AIP from pancreatic malignancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical, biochemical, histological and radiological details of all AIP patients 1997\u20132016 were analysed. The initial imaging was re\u2010reviewed according to international guidelines by three blinded independent radiologists to evaluate features associated with autoimmune pancreatitis and pancreatic cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were a total of 45 patients: 25\u00a0in type 1 (55.5%), 14 type 2 (31.1%) and 6 AIP otherwise not specified (13.3%). The median (IQR) age was 57 (51\u201370) years. Thirty patients (66.6%) were male. Twenty\u2010six patients (57.8%) had resection for suspected malignancy and one for symptomatic chronic pancreatitis. Three had histologically proven malignancy with concurrent AIP. Two patients died from recurrent pancreatic cancer following resection. Multidisciplinary team review based on radiology and clinical history dictated management. Resected patients (vs. non\u2010resected group) were older (64 vs. 53, <jats:italic>p<\/jats:italic>\u2009=\u20090.003) and more frequently had co\u2010existing autoimmune pathologies (22.2 vs. 55.6%, <jats:italic>p<\/jats:italic>\u2009=\u20090.022). Resected patients also presented with less classical radiological features of AIP, which are halo sign (0\/25 vs. 3\/17, <jats:italic>p<\/jats:italic>\u2009=\u20090.029) and loss of pancreatic clefts (18\/25 vs. 17\/17, <jats:italic>p<\/jats:italic>\u2009=\u20090.017). There were no differences in demographic features other than age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite international guidelines for diagnosing AIP, differentiation from pancreatic cancer remains challenging. Resection remains an important treatment option in suspected cancer or where conservative treatment fails.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-04928-w","type":"journal-article","created":{"date-parts":[[2019,2,28]],"date-time":"2019-02-28T03:07:42Z","timestamp":1551323262000},"page":"1604-1611","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Differentiation of Autoimmune Pancreatitis from Pancreatic Cancer Remains Challenging"],"prefix":"10.1002","volume":"43","author":[{"given":"L. D.","family":"Dickerson","sequence":"first","affiliation":[{"name":"Pancreas Unit, Department of General Surgery Royal Liverpool University Hospital Prescot Street L7 8XP Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Farooq","sequence":"additional","affiliation":[{"name":"Department of Radiology Royal Liverpool University Hospital Prescot Street L7 8XP Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Bano","sequence":"additional","affiliation":[{"name":"Department of Radiology Royal Liverpool University Hospital Prescot Street L7 8XP Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Kleeff","sequence":"additional","affiliation":[{"name":"Department of Visceral, Vascular and Endocrine Surgery Martin\u2010Luther\u2010University Halle\u2010Wittenberg 06120 Halle (Saale) Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Baron","sequence":"additional","affiliation":[{"name":"Pancreas Unit, Department of General Surgery Royal Liverpool University Hospital Prescot Street L7 8XP Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Raraty","sequence":"additional","affiliation":[{"name":"Pancreas Unit, Department of General Surgery Royal Liverpool University Hospital Prescot Street L7 8XP Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Ghaneh","sequence":"additional","affiliation":[{"name":"Pancreas Unit, Department of General Surgery Royal Liverpool University Hospital Prescot Street L7 8XP Liverpool UK"},{"name":"Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine University of Liverpool L69 3GA Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Sutton","sequence":"additional","affiliation":[{"name":"Pancreas Unit, Department of General Surgery Royal Liverpool University Hospital Prescot Street L7 8XP Liverpool UK"},{"name":"Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine University of Liverpool L69 3GA Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Whelan","sequence":"additional","affiliation":[{"name":"Pancreas Unit, Department of General Surgery Royal Liverpool University Hospital Prescot Street L7 8XP Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Pathology Royal Liverpool University Hospital Prescot Street L7 8XP Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Healey","sequence":"additional","affiliation":[{"name":"Department of Radiology Royal Liverpool University Hospital Prescot Street L7 8XP Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. P.","family":"Neoptolemos","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine University of Liverpool L69 3GA Liverpool UK"},{"name":"Department of General, Visceral and Transplantation Surgery University of Heidelberg Im Neuenheimer Feld 110 69120 Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. S.","family":"Yip","sequence":"additional","affiliation":[{"name":"Pancreas Unit, Department of General Surgery Royal Liverpool University Hospital Prescot Street L7 8XP Liverpool UK"},{"name":"Department of Hepatobiliary and Pancreas Surgery 13C Royal London Hospital Whitechapel Road E1 1BB London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,27]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0b013e3182142fd2"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(16)00097\u20100"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.03.010"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.170.5.9574610"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.07.2309"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rcl.2012.03.005"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2016.12.003"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2008.172908"},{"key":"e_1_2_7_10_2","unstructured":"Office for National Statistics(2015)Cancer Registration Statistics England.https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/conditionsanddiseases\/bulletins\/cancerregistrationstatisticsengland\/2015. 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