Clinicopathological feature of follicular pancreatitis

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  • Ryota Hironori
    Department of Surgery, Kansai Medical University
  • Ishida Mitsuaki
    Department of Pathology and Laboratory Medicine, Kansai Medical University
  • Satoi Sohei
    Department of Surgery, Kansai Medical University
  • Tsuta Koji
    Department of Pathology and Laboratory Medicine, Kansai Medical University

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  • Follicular pancreatitisの臨床病理学的検討
  • Follicular pancreatitis ノ リンショウ ビョウリガクテキ ケントウ

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Abstract

<p>Follicular pancreatitis is characterized by the presence of many intrapancreatic lymphoid follicles with reactive germinal centers. However, its clinicopathological features and cause have not yet been established. We assessed the clinicopathological features with follicular pancreatitis who underwent surgery. This study included 3 patients with a pancreatic mass. Histopathological study of the resected pancreatic mass revealed that abundant lymphoid follicles with reactive germinal centers were present in both periductal regions and were diffused in parenchyma. Podoplanin (Th17 marker)-expressing lymphocytes were present in lymphoid follicles of those with follicular pancreatitis, whereas these were absent in normal lymph nodes and in lymphoid follicles of those with IgG4-related autoimmune pancreatitis (AIP). RNA digital counting assay clearly demonstrated that the expression counts of 20 genes, including dendritic cells and lymphoid follicles markers, and related cytokines were significantly higher in follicular pancreatitis than in IgG4-related AIP (p<0.01). The expression of IL23A, which are genes related to Th17, was high. This study shows that follicular pancreatitis is a histopathologically and immunologically distinct disease entity of pancreatitis and is characterized by upregulated Th17 expression.</p>

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