Sclerosing cholecystitis associated with autoimmune pancreatitis

瞄准：与自体免疫的胰腺炎(AIP ) 在病人评估胆囊的组织病理学说、放射学的调查结果。方法：19 个 AIP 病人的胆囊的放射学的调查结果回顾地被考察。8 个 AIP 病人的 Resected 胆囊组织学地被检验，免疫与 anti-IgG4 抗体被染色。控制为征兆的胆石由胆囊 resected 组成了(n = 10 ) 并且那些为胰腺的癌在胰头十二指肠切除术期间搬迁了(n = 10 ) ，以及额外的肝的胆汁管和胰为胰腺的癌由胰头十二指肠切除术搬迁了(n = 10 ) 。结果：胆囊墙变厚被超声检测或与 AIP 在 10 个病人计算了断层摄影术(3 严重并且 7 中等) ；在这些病人，额外的肝的胆汁管的严重狭窄也被注意。组织学地，胆囊变厚在 8 中的 6 个被检测(75%) 有 AIP 的病人；4 个盒子与纤维变性有透壁 lymphoplasmacytic 渗入，并且 2 个盒子有基于 mucosal 的 lymphoplasmacytic 渗入。与稠密的纤维变性和弥漫的 lymphoplasmacytic 渗入的额外的肝的胆汁管墙的可观的透壁的变厚在 7 个病人被检测。Immunohistochemically， IgG4 积极的浆细胞的严重或中等的渗入在所有 8 个病人的胆囊，胆汁管，和胰被检测，但是没在控制被检测。结论：胆囊墙与纤维变性和 IgG4 积极的血浆房间的丰富的渗入变厚经常与 AIP 在病人被检测。我们建议一个新术语的使用，致硬化的胆汁，为这些盒子，那被象致硬化的胰腺炎或致硬化的胆管炎的一样的机制在 AIP 导致。

AIM： TO evaluate the histopathological and radiological findings of the gallbladder in patients with autoimmune pancreatitis （AIP）. METHODS： The radiological findings of the gallbladder of 19 AIP patients were retrospectively reviewed. Resected gallbladders of 8 AIP patients were examined histologically and were immunostained with anti- IgG4 antibody. Controls consisted of gallbladders resected for symptomatic gallstones （n = 10） and those removed during pancreatoduodenectomy for pancreatic carcinoma （n = 10）, as well as extrahepatic bile ducts and pancreases removed by pancreatoduodenectomy for pancreatic carcinoma （n = 10）. RESULTS： Thickening of the gallbladder wall was detected by ultrasound and/or computed tomography in 10 patients with AIP （3 severe and 7 moderate）; in these patients severe stenosis of the extrahepatic bile duct was also noted. Histologically, thickening of the gallbladder was detected in 6 of 8 （75%） patients with AIP; 4 cases had transmural lymphoplasmacytic infiltration with fibrosis, and 2 cases had mucosal-based lymphoplasmacytic infiltration. Considerable transmural thickening of the extrahepatic bile duct wall with dense fibrosis and diffuse ly,mphoplasmacytic infiltration was detected in 7 patients. Immunohistochemically, severeor moderate infiltration of IgG4-positive plasma cells was detected in the gallbladder, bile duct, and pancreas of all 8 patients, but was not detected in controls. CONCLUSION： Gallbladder wall thickening with fibrosis and abundant infiltration of IgG4-positive plasma cells is frequently detected in patients with AIP. We propose the use of a new term, sclerosing cholecystitis, for these cases that are induced by the same mechanism as sclerosing pancreatitis or sclerosing cholangitis in AIP.