{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T06:16:06Z","timestamp":1780380966413,"version":"3.54.1"},"reference-count":50,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T00:00:00Z","timestamp":1611014400000},"content-version":"vor","delay-in-days":49,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ultrasound Int Open"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Autoimmune pancreatitis is a chronic fibroinflammatory autoimmune mediated\n                        disease of the pancreas. Clinically, obstructive painless jaundice and upper\n                        abdominal pain are the main symptoms. Focal AIP is characterized by\n                        segmental involvement of pancreatic parenchyma and it is often\n                        radiologically represented by a pancreatic mass. In these cases, the\n                        diagnosis can be very challenging, since it may be easily confused with\n                        pancreatic cancer. Therefore, we suggest a combined approach of imaging\n                        tests as the diagnostic workup. EUS study combined with CEUS and\n                        elastography, if available, increases the accuracy of the method to rule out\n                        cancer. Moreover, the lesion should always be sampled under EUS guidance to\n                        obtain a cyto\/histological diagnosis. The diagnostic workup should\n                        also include the use of diagnostic clinical criteria (extrapancreatic\n                        lesions, steroid response) and laboratory findings (CA 19.9 and IgG4\n                        evaluations).<\/jats:p>","DOI":"10.1055\/a-1323-4906","type":"journal-article","created":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T00:15:13Z","timestamp":1611101713000},"page":"E67-E75","source":"Crossref","is-referenced-by-count":8,"title":["Focal Autoimmune Pancreatitis: A Simple Flow Chart for a Challenging\n                    Diagnosis"],"prefix":"10.1055","volume":"06","author":[{"given":"Clara Benedetta","family":"Conti","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, ASST Cremona, Cremona,\n                    Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Cereatti","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, ASST Cremona, Cremona,\n                    Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Drago","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, ASST Cremona, Cremona,\n                    Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Grassia","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, ASST Cremona, Cremona,\n                    Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,1,19]]},"reference":[{"key":"ref1","first-page":"585","article-title":"Diagnostic criteria for autoimmune pancreatitis by the Japan Pancreas Society\n                    (2002)","volume":"17","year":"2002","journal-title":"J Jpn Pancreas Soc (Suizou)"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/j.cgh.2009.04.020","article-title":"A diagnostic strategy to distinguish autoimmune pancreatitis from pancreatic\n                    cancer","volume":"7","author":"S T Chari","year":"2009","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1097\/MPA.0b013e31802eff5f","article-title":"The diagnostic criteria for autoimmune chronic pancreatitis: it is time to make\n                    a consensus","volume":"34","author":"S Kwon","year":"2007","journal-title":"Pancreas"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1007\/s00535-008-2205-6","article-title":"Asian diagnostic criteria for autoimmune pancreatitis: consensus of the\n                    Japan-Korea Symposium on Autoimmune Pancreatitis","volume":"43","author":"M Otsuki","year":"2008","journal-title":"J Gastroenterol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1007\/s00108-008-2262-1","article-title":"[Autoimmune pancreatitis]","volume":"50","author":"A Schneider","year":"2009","journal-title":"Internist (Berl)"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00006676-200307000-00001","article-title":"Controversies in clinical pancreatology: autoimmune pancreatitis: does it\n                    exist?","volume":"27","author":"R K Pearson","year":"2003","journal-title":"Pancreas."},{"key":"ref7","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1097\/MPA.0b013e3182142fd2","article-title":"\u201cInternational consensus diagnostic criteria for autoimmune\n                    pancreatitis: Guidelines of the international association of\n                    pancreatology,\u201d","volume":"3","author":"T Shimosegawa","year":"2011","journal-title":"Pancreas"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1412","DOI":"10.1038\/s41395-018-0184-7","article-title":"Current concept of autoimmune pancreatitis and IgG4-related disease","volume":"113","author":"K Okazaki","year":"2018","journal-title":"Am J Gastroenterol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1016\/S0140-6736(14)60720-0","article-title":"IgG4-related disease","volume":"385","author":"T Kamisawa","year":"2015","journal-title":"The Lancet"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s00535-009-0184-x","article-title":"Japanese consensus guidelines for management of autoimmune pancreatitis: I.\n                    Concept and diagnosis of autoimmune pancreatitis","volume":"45","author":"K Okazaki","year":"2010","journal-title":"J Gastroenterol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"2679","DOI":"10.1111\/j.1572-0241.2003.08727.x","article-title":"Clinical and imaging features of autoimmune pancreatitis with focal pancreatic\n                    swelling or mass formation: comparison with so-called tumor-forming pancreatitis\n                    and pancreatic carcinoma","volume":"98","author":"T Wakabayashi","year":"2003","journal-title":"Am J Gastroenterol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S1091-255X(02)00148-8","article-title":"Lymphoplasmacytic sclerosing pancreatitis: inflammatory mimic of pancreatic\n                    carcinoma","volume":"7","author":"S M Weber","year":"2003","journal-title":"J Gastrointest Surg"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1097\/00000478-200301000-00012","article-title":"Pancreaticoduodenectomy (Whipple resections) in patients without malignancy: Are\n                    they all \u2018chronic pancreatitis\u2019?","volume":"27","author":"S C Abraham","year":"2003","journal-title":"Am J Surg Pathol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.amjsurg.2005.10.051","article-title":"Bell et al. Incidence of benign inflammatory disease in patients undergoing\n                    Whipple procedure for clinically suspected carcinoma: a single-institution\n                    experience","volume":"191","author":"T Kennedy","year":"2006","journal-title":"Am J Surg"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.amjsurg.2009.09.011","article-title":"Pancreaticoduodenectomies in patients without periampullary neoplasms: lesions\n                    that masquerade as cancer","volume":"199","author":"M G Hurtuk","year":"2010","journal-title":"Am J Surg"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1007\/s11605-010-1196-9","article-title":"Incidence of benign disease in patients that underwent resection for presumed\n                    pancreatic cancer diagnosed by endoscopic ultrasonography (EUS) and fine-needle\n                    aspiration (FNA)","volume":"14","author":"S G De la Fuente","year":"2010","journal-title":"J Gastrointest Surg"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"2076","DOI":"10.3748\/wjg.v17.i16.2076","article-title":"A practical approach to the diagnosis of autoimmune pancreatitis","volume":"17","author":"L Frulloni","year":"2011","journal-title":"World J Gastroenterol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1159\/000499762","article-title":"Pancreatic solid focal lesions: differential diagnosis between autoimmune\n                    pancreatitis and pancreatic cancer","volume":"37","author":"P Dite","year":"2019","journal-title":"Dig Dis"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.pan.2014.07.010","article-title":"Increase diagnostic accuracy in differentiating focal type autoimmune\n                    pancreatitis from pancreatic cancer with combined serum IgG4 and CA19-9\n                    levels","volume":"14","author":"M C Chang","year":"2014","journal-title":"Pancreatology"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"867","DOI":"10.3748\/wjg.v17.i7.867","article-title":"Advances in diagnosis, treatment and palliation of pancreatic carcinoma:\n                    1990\u20132010","volume":"17","author":"C Sharma","year":"2011","journal-title":"World J Gastroenterol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.pan.2017.11.007","article-title":"Multicenter study of early pancreatic cancer in Japan","volume":"18","author":"A Kanno","year":"2018","journal-title":"Pancreatology"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"2","DOI":"10.3390\/diagnostics9010002. 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Park","year":"2014","journal-title":"Ultrasonography"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1007\/s00330-014-3512-3","article-title":"Differentiation of focal-type autoimmune pancreatitis from pancreatic carcinoma:\n                    assessment by multiphase contrast-enhanced CT","volume":"25","author":"N Furuhashi","year":"2015","journal-title":"Eur Radiol"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1471-2288-10-21","article-title":"A nomogram for P values","volume":"10","author":"L Held","year":"2010","journal-title":"BMC Med Res Methodol"},{"key":"ref27","first-page":"146","article-title":"Differentiating autoimmune pancreatitis from pancreatic adenocarcinoma using\n                    dual-phase computed tomography","volume":"38","author":"A Zaheer","year":"2014","journal-title":"J Comput Assist Tomogr"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1186\/s12885-017-3665-y","article-title":"18F- FDG PET\/CT helps differentiate autoimmune pancreatitis from\n                    pancreatic cancer","volume":"17","author":"J Zhang","year":"2017","journal-title":"BMC Cancer"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1016\/j.cgh.2012.12.033","article-title":"18-Fluorodeoxyglucose positron emission tomography does not aid in diagnosis of\n                    pancreatic ductal adenocarcinoma","volume":"11","author":"I Matsumoto","year":"2013","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.2147\/CIA.S115254","article-title":"Application of 18F-FDG PET\/CT combined with carbohydrate antigen 19-9\n                    for differentiating pancreatic carcinoma from chronic mass-forming pancreatitis\n                    in Chinese elderly","volume":"11","author":"X Gu","year":"2016","journal-title":"Clin Interv Aging"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"5763","DOI":"10.1007\/s00330-019-06200-0","article-title":"Differentiating focal autoimmune pancreatitis and pancreatic ductal\n                    adenocarcinoma: contrast-enhanced MRI with special emphasis on the arterial\n                    phase","volume":"29","author":"J H Kwon","year":"2019","journal-title":"Eur Radiol"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"3634","DOI":"10.3748\/wjg.v19.i23.3634","article-title":"Focal autoimmune pancreatitis: radiological characteristics help to distinguish\n                    from pancreatic cancer","volume":"19","author":"G F Sun","year":"2013","journal-title":"World J Gastroenterol"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1016\/j.ejrad.2015.05.012","article-title":"Missed pancreatic ductal adenocarcinoma: Assessment of early imaging findings on\n                    prediagnostic magnetic resonance imaging","volume":"84","author":"K M Jang","year":"2015","journal-title":"Eur J Radiol"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.clinimag.2019.02.013","article-title":"Usefulness of non-contrast MR imaging in distinguishing pancreatic ductal\n                    adenocarcinoma from focal pancreatitis","volume":"55","author":"J H Lee","year":"2019","journal-title":"Clin Imaging"},{"key":"ref35","first-page":"78","article-title":"Endoscopic ultrasonography findings in autoimmune pancreatitis: be aware of the\n                    ambiguous features and look for the pivotal ones","volume":"11","author":"S De Lisi","year":"2010","journal-title":"JOP"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/S0016-5107(91)70729-3","article-title":"Endoscopic ultrasound in pancreatic tumor diagnosis","volume":"37","author":"T R\u00f6sch","year":"1991","journal-title":"Gastrointest Endosc"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1055\/s-0043-109021","article-title":"Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided\n                    sampling in gastroenterology: European Society of Gastrointestinal Endoscopy\n                    (ESGE) Clinical Guideline - Updated January 2017","volume":"49","author":"J M Dumonceau","year":"2017","journal-title":"Endoscopy"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.pan.2013.01.013","article-title":"Diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration for\n                    pancreatic cancer: a meta-analysis","volume":"13","author":"G Chen","year":"2013","journal-title":"Pancreatology"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1111\/j.1572-0241.2003.07472.x","article-title":"Clinical impact of on-site cytopathology interpretation on endoscopic\n                    ultrasound-guided fine needle aspiration","volume":"98","author":"J B Klapman","year":"2003","journal-title":"Am J Gastroenterol"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"454","DOI":"10.4253\/wjge.v11.i8.454","article-title":"Endoscopic ultrasound-guided sampling of solid pancreatic masses: the fine\n                    needle aspiration or fine needle biopsy dilemma. Is the best needle yet to\n                    come?","volume":"11","author":"C B Conti","year":"2019","journal-title":"World J Gastrointest Endosc"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"S30","DOI":"10.1055\/s-2006-946648","article-title":"Chronic pancreatitis: focal pancreatitis or cancer? Is there a role for\n                    FNA\/biopsy? Autoimmune pancreatitis","volume":"38","author":"M J Levy","year":"2006","journal-title":"Endoscopy."},{"key":"ref42","first-page":"122","article-title":"EUS-guided tissue acquisition in chronic pancreatitis: Differential diagnosis\n                    between pancreatic cancer and pseudotumoral masses using EUS-FNA or core biopsy.\n                    Endoscopic","volume":"9","author":"R Grassia","year":"2020","journal-title":"Ultrasound"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"196","DOI":"10.4103\/eus.eus_23_17","article-title":"Autoimmune pancreatitis: Imaging features","volume":"7","author":"Y Dong","year":"2018","journal-title":"Endosc Ultrasound"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"591","DOI":"10.5009\/gnl17391","article-title":"Contrast-Enhanced Endoscopic Ultrasound for Differentially Diagnosing Autoimmune\n                    Pancreatitis and Pancreatic Cancer","volume":"12","author":"M K Cho","year":"2018","journal-title":"Gut Liver"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1055\/s-0041-103847","article-title":"Quantitative perfusion analysis in pancreatic contrast enhanced ultrasound\n                    (DCE-US): A promising tool for the differentiation between autoimmune\n                    pancreatitis and pancreatic cancer","volume":"53","author":"F Vitali","year":"2015","journal-title":"Z Gastroenterol"},{"key":"ref46","doi-asserted-by":"crossref","first-page":"533","DOI":"10.5946\/ce.2018.156","article-title":"Elastography of the pancreas","volume":"52","author":"C F Dietrich","year":"2019","journal-title":"Current viewClin Endosc"},{"key":"ref47","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/5584_2018_303","article-title":"Elastography in the Diagnosis of Pancreatic Malignancies","volume":"1133","author":"P Dyrla","year":"2019","journal-title":"Adv Exp Med Biol"},{"key":"ref48","doi-asserted-by":"crossref","first-page":"e11689","DOI":"10.1097\/MD.0000000000011689","article-title":"Endoscopic ultrasound (EUS) elastography and strain ratio, could it help in\n                    differentiating malignant from benign pancreatic lesions?","volume":"97","author":"H H Okasha","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"ref49","doi-asserted-by":"crossref","first-page":"5962","DOI":"10.3748\/wjg.v23.i32.5962","article-title":"Real time endoscopic ultrasound elastography an strain ratio in the diagnosis of\n                    solid pancreatic lesions","volume":"23","author":"H Okasha","year":"2017","journal-title":"World J Gastroenterol"},{"key":"ref50","doi-asserted-by":"crossref","first-page":"150","DOI":"10.11152\/mu-987","article-title":"Diagnostic utility of endoscopic ultrasonography-elastography in the evaluation\n                    of solid pancreatic masses: A meta-analysis and systematic review","volume":"19","author":"Y Lu","year":"2017","journal-title":"Med Ultrason"}],"container-title":["Ultrasound International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1323-4906.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T00:15:27Z","timestamp":1611101727000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1323-4906"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":50,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2020,12,8]]},"published-print":{"date-parts":[[2020,12]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1323-4906","relation":{},"ISSN":["2509-596X","2199-7152"],"issn-type":[{"value":"2509-596X","type":"print"},{"value":"2199-7152","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12]]}}}