Document Detail


Renal cortical lesions in patients with autoimmune pancreatitis: a clue to differentiation from pancreatic malignancy.
MedLine Citation:
PMID:  17826935     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To describe the occurrence of renal cortical lesions (RCLs) in patients with autoimmune pancreatitis (AIP). METHODS: This retrospective study was approved by our research ethics board; informed consent was waived. Systematic search of CT scan reports in 5-year interval yielded 17 patients with AIP (male:female; 11:6, age 18-80 years). A consecutive group of 22 patients with pancreatic adenocarcinoma was used as control (male:female; 10:12, age 42-76 years). The CT scans of the two groups were mixed and randomized. Two blinded radiologists independently reviewed the kidneys for the presence of wedge-shaped RCLs. Fisher's exact test was used to determine statistical significance. Consensus review of all imaging of positive patients with AIP and RCLs and three additional patients identified anecdotally was performed. RESULTS: Both readers independently identified the same 6/17 (35%) patients in the study group and 0/22 in the control group with two or more RCLs. This difference was statistically significant (p=0.004). The sensitivity, specificity, positive and negative predictive values of RCLs in the differentiation of AIP from pancreatic adenocarcinoma were 35%, 100%, 100%, and 67%, respectively. To the six AIP patients with RCLs, we added three more identified anecdotally. In 7/9, >5 RCLs were seen which were wedge-shaped and cortical-based, ranging from <1 to 4cm. Typical pancreatic findings of AIP were noted in all, with the gland affected focally in 5/9 patients. CONCLUSION: We have shown the presence of multiple renal cortical lesions which occur in approximately 35% of our AIP patient population.
Authors:
Korosh Khalili; Deirdre J Doyle; Tanya P Chawla; Anthony E Hanbidge
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Publication Detail:
Type:  Journal Article     Date:  2007-09-10
Journal Detail:
Title:  European journal of radiology     Volume:  67     ISSN:  0720-048X     ISO Abbreviation:  Eur J Radiol     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-14     Completed Date:  2009-01-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  329-35     Citation Subset:  IM    
Affiliation:
Department of Medical Imaging, University Health Network and Mount Sinai Hospital, Toronto, ON, Canada. Korosh.Khalili@uhn.on.ca <Korosh.Khalili@uhn.on.ca>
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Autoimmune Diseases / complications*
Case-Control Studies
Diagnosis, Differential
Female
Humans
Image Interpretation, Computer-Assisted
Kidney Diseases / epidemiology,  etiology*,  radiography*
Male
Middle Aged
Pancreatitis / complications*
Predictive Value of Tests
Prevalence
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed

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