Lymphoplasmacytic sclerosing pancreatitis: Inflammatory mimic of pancreatic carcinoma

Sharon M. Weber, Olcay Cubukcu-Dimopulo, J. Alexander Palesty, Arief Suriawinata, David Klimstra, Murray F. Brennan, Kevin Conlon, A. L. Warshaw, S. Weber, D. O'Toole, Kevin Billingsley, K. S. Kirkwood, L. William Traverso

Research output: Contribution to journalArticle

232 Citations (Scopus)

Abstract

Lymphoplasmacytic sclerosing pancreatitis (LP) is a rare cause of benign mass lesions of the pancreas that can resemble adenocarcinoma. This study evaluates and classifies a series of patients with LP. Patients with benign pancreatic disease were identified from a prospective pancreatic database, and these cases were reviewed to identify patients with LP. Patients were subdivided into two groups: (1) classic LP, which included those patients who had all four of the characteristic histologic features of LP, including lymphoplasmacytic infiltration of the pancreas, interstitial fibrosis, periductal inflammation, and periphlebitis; and (2) intermediate LP, which included patients with at least two of these histologic findings. Patient demographics, pathologic and clinical features, and outcome were analyzed. From 1985 to 2001, a total of 1287 pancreatic resections were performed at our institution, of which 159 were for benign disease. Of these, 31 had pathologic features consistent with LP, and all of these patients had a presumed preoperative diagnosis of pancreatic carcinoma. Most of these patients presented with jaundice (n = 21) or abdominal pain (n = 7). In 29 of 31 patients, curative resection was possible. Of these, 28% (8/29) developed recurrence after resection: seven with jaundice and one with recurrent pancreatitis (median time to recurrence, 11 months; median follow up, 38 months). All patients with recurrent jaundice appeared to have biliary strictures at the time of direct cholangiography and no patient had malignancy. A review of the pathology reports identified 19 patients with classic LP and 12 patients with intermediate LP, and there was no difference between these two groups. LP is a rare cause of pancreatitis that is difficult to differentiate from carcinoma preoperatively. Patients with classic and intermediate LP appear to demonstrate a similar clinical behavior. Nearly one third of patients have a progressive course after resection, with 25% developing recurrent jaundice; thus close follow-up is mandatory for all patients.

Original languageEnglish (US)
Pages (from-to)129-139
Number of pages11
JournalJournal of Gastrointestinal Surgery
Volume7
Issue number1
DOIs
StatePublished - Jan 2003
Externally publishedYes

Fingerprint

Pancreatitis
Jaundice
Pancreatic Carcinoma
Pancreas
Phlebitis
Recurrence
Pancreatic Diseases
Cholangiography
Abdominal Pain
Pathologic Constriction
Adenocarcinoma

Keywords

  • Autoimmune pancreatitis
  • Sclerosing pancreatitis

ASJC Scopus subject areas

  • Surgery

Cite this

Weber, S. M., Cubukcu-Dimopulo, O., Palesty, J. A., Suriawinata, A., Klimstra, D., Brennan, M. F., ... Traverso, L. W. (2003). Lymphoplasmacytic sclerosing pancreatitis: Inflammatory mimic of pancreatic carcinoma. Journal of Gastrointestinal Surgery, 7(1), 129-139. https://doi.org/10.1016/S1091-255X(02)00148-8

Lymphoplasmacytic sclerosing pancreatitis : Inflammatory mimic of pancreatic carcinoma. / Weber, Sharon M.; Cubukcu-Dimopulo, Olcay; Palesty, J. Alexander; Suriawinata, Arief; Klimstra, David; Brennan, Murray F.; Conlon, Kevin; Warshaw, A. L.; Weber, S.; O'Toole, D.; Billingsley, Kevin; Kirkwood, K. S.; Traverso, L. William.

In: Journal of Gastrointestinal Surgery, Vol. 7, No. 1, 01.2003, p. 129-139.

Research output: Contribution to journalArticle

Weber, SM, Cubukcu-Dimopulo, O, Palesty, JA, Suriawinata, A, Klimstra, D, Brennan, MF, Conlon, K, Warshaw, AL, Weber, S, O'Toole, D, Billingsley, K, Kirkwood, KS & Traverso, LW 2003, 'Lymphoplasmacytic sclerosing pancreatitis: Inflammatory mimic of pancreatic carcinoma', Journal of Gastrointestinal Surgery, vol. 7, no. 1, pp. 129-139. https://doi.org/10.1016/S1091-255X(02)00148-8
Weber SM, Cubukcu-Dimopulo O, Palesty JA, Suriawinata A, Klimstra D, Brennan MF et al. Lymphoplasmacytic sclerosing pancreatitis: Inflammatory mimic of pancreatic carcinoma. Journal of Gastrointestinal Surgery. 2003 Jan;7(1):129-139. https://doi.org/10.1016/S1091-255X(02)00148-8
Weber, Sharon M. ; Cubukcu-Dimopulo, Olcay ; Palesty, J. Alexander ; Suriawinata, Arief ; Klimstra, David ; Brennan, Murray F. ; Conlon, Kevin ; Warshaw, A. L. ; Weber, S. ; O'Toole, D. ; Billingsley, Kevin ; Kirkwood, K. S. ; Traverso, L. William. / Lymphoplasmacytic sclerosing pancreatitis : Inflammatory mimic of pancreatic carcinoma. In: Journal of Gastrointestinal Surgery. 2003 ; Vol. 7, No. 1. pp. 129-139.
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