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Diagnostic criteria | Japanese criteria(2006) [55] | SIHORts (2006) [57] | Korean criteria (2007) [56] | Asian criteria (2008) [58] |
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A: imaging | Diffuse or segmental narrowing of the MPD; diffuse or localized enlargement of the pancreas | Typical imaging features: diffusely enlarged gland with delayed (rim) enhancement; diffusely irregular and attenuated MPD Atypical imaging features: focal pancreatic mass, focal pancreatic duct stricture | Diffuse enlargement of pancreas and diffuse or segmental irregular narrowing of MPD | Typical imaging features: diffusely enlarged gland with delayed (rim) enhancement; diffusely irregular and attenuated MPD Atypical imaging features: focal pancreatic mass, focal pancreatic duct stricture |
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B: serology | High serum γ globulin, IgG, IgG4, or the presence of autoantibodies | Elevated serum IgG4 level | Elevated levels of IgG and/or IgG4 or detected autoantibodies | High level of serum IgG or IgG4 or detected autoantibodies |
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C: histology | Infiltration of lymphocytes and plasma cells | Lymphoplasmacytic infiltrate with storiform fibrosis showing abundant | Fibrosis and lymphoplasmacytic infiltration | Lymphoplasmacytic infiltration with fibrosis, with abundant IgG4-positive cell infiltration |
(>10 cells/HPF) IgG4-positive cells |
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D: other organ involvement | Not included | Biliary stricture, parotid/lacrimal gland involvement, mediastinal lymphadenopathy, retroperitoneal fibrosis | Included | Not included |
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E: steroid effect | Not included | Included | Included | Included |
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Definite diagnosis | Criterion A + B Criterion A + C | Criterion A + B Criterion A + C Criterion A + D Criterion A + E | Criterion A + B Criterion A + C Criterion A + D Criterion A + E | Criterion A + B Criterion A + C Histology shows the presence of lymphoplasmacytic sclerosing pancreatitis in the resected pancreas |
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