CAJ | 학술논문

目的：探讨自身免疫性胰腺炎（ AIP）两个亚型临床病理特点及诊断和鉴别诊断要点。方法结合临床病史，对3例AIP标本进行病理形态学观察和免疫组织化学染色分析，并进行文献复习。结果2例Ⅰ型AIP，组织学表现为胰管扩张，周围淋巴、浆细胞浸润，伴席纹状纤维化；免疫组化IgG4>10/HPF，IgG4/IgG>40%。1例Ⅱ型AIP，组织学表现为胰管扩张，周围淋巴、浆细胞浸润，并见导管上皮及腺腔内中性粒细胞浸润；免疫组化仅显示个别IgG4阳性细胞。结论 AIP是一种特殊类型的慢性胰腺炎，两个亚型临床病理特点存在差异，本病预后良好，正确的诊断对临床治疗有重要指导意义。
목적：탐토자신면역성이선염（ AIP）량개아형림상병리특점급진단화감별진단요점。방법결합림상병사，대3례AIP표본진행병리형태학관찰화면역조직화학염색분석，병진행문헌복습。결과2례Ⅰ형AIP，조직학표현위이관확장，주위림파、장세포침윤，반석문상섬유화；면역조화IgG4>10/HPF，IgG4/IgG>40%。1례Ⅱ형AIP，조직학표현위이관확장，주위림파、장세포침윤，병견도관상피급선강내중성립세포침윤；면역조화부현시개별IgG4양성세포。결론 AIP시일충특수류형적만성이선염，량개아형림상병리특점존재차이，본병예후량호，정학적진단대림상치료유중요지도의의。
Objective To investigate the clinical and pathological features,diagnosis,and differential diagnosis of two subtypes of auto-immune pancreatitis( AIP). Methods Combined with the clinical history,3 cases of AIP specimen were analyzed by light microscopy and immu-nohistochemistry,and related literatures had been reviewed. Results For 2 cases of type-1 AIP,the morphology manifested dilated pancreatic duct,lymphocytes and plasma cells infiltration,and storiform fibrosis. Immunohistochemistry demonstrated IgG4 >10/HPF,IgG4/IgG>40%. For 1 case of type-2 AIP,the morphology manifested dilated pancreatic duct,lymphocytes and plasma cells infiltration,and neutrophilic infiltra-tion within the lumen and epithelium of the interlobular ducts. Immunohistochemistry demonstrated few IgG4 positive cells. Conclusion AIP is a form of idiopathic chronic pancreatitis. The clinical and pathological features of two subtypes are different. The prognosis of AIP is good. The cor-rect diagnosis has guiding significance for clinical therapy.