[[Computed tomography]] (CT) findings in AIP include a diffusely enlarged hypoechoic pancreas or a focal mass that may be mistaken for a pancreatic malignancy. A low-density, capsule-like rim on CT (possibly corresponding to an inflammatory process involving peripancreatic tissues) is thought to be an additional characteristic feature. [[Magnetic resonance imaging]] (MRI) reveals a diffusely decreased signal intensity and delayed enhancement on dynamic scanning. The characteristic [[ERCP]] finding is segmental or diffuse irregular narrowing of the main pancreatic duct, usually accompanied by an extrinsic-appearing stricture of the distal bile duct. Changes in the extrapancreatic bile duct similar to those of [[primary sclerosing cholangitis]] (PSC) have been reported.
The role of [[endoscopic ultrasound]] (EUS) and EUS-guided [[fine-needle aspiration]] (EUS-FNA) in the diagnosis of AIP is not well described, and EUS findings have been described in only a small number of patients. In one study, EUS revealed a diffusely swollen and hypoechoic pancreas in 8 of the 14 (57%) patients, and a solitary, focal, irregular mass was observed in 6 (46%) patients. Whereas EUS-FNA is sensitive and specific for the diagnosis of pancreatic malignancy, its role in the diagnosis of AIP remains unclear.
=== Electrocardiogram ===
===Other Diagnostic Studies===
=== X-ray ===
=== Echocardiography and Ultrasound ===
=== CT scan ===
=== MRI ===
=== Other Imaging Findings ===
=== Other Diagnostic Studies ===
==Treatment==
==Treatment==
===Medical Therapy===
===Medical Therapy===
AIP often completely resolves with steroid treatment. The failure to differentiate AIP from malignancy may lead to unnecessary pancreatic resection, and the characteristic lymphoplasmacytic infiltrate of AIP has been found in up to 23% of patients undergoing pancreatic resection for suspected malignancy who are ultimately found to have benign disease. In this subset of patients, a trial of steroid therapy may have prevented a [[Whipple procedure]] or complete [[pancreatectomy]] for a benign disease which responds well to medical therapy.
Synonyms and keywords: Primary inflammatory pancreatitis, lymphoplasmacytic sclerosing pancreatitis, pseudotumorous pancreatitis, chronic pancreatitis with irregular narrowing of the main pancreatic duct, and nonalcoholic duct destructive chronic pancreatitis.
