Granulocytic epithelial lesion (GEL) in heterotopic pancreas

The diagnosis of type 2 autoimmune pancreatitis (AIP) is dependent on typical radiologic imaging and the presence of the granulocytic epithelial lesion (GEL), which is characterized by ductal neutrophilic infiltration with or without neutrophilic acinar infiltration. We evaluated GEL and related cli...

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Bibliographic Details
Published in:Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2022-04, Vol.22 (3), p.435-442
Main Authors: Jun, Sun-Young, Chun, Jihyun, Kim, Sung Joo, Oh, Dongwook, Kim, Jin Hee, Kim, Myung-Hwan, Hong, Seung-Mo
Format: Article
Language:English
Subjects:
Autoimmune pancreatitis
Biopsy
Cancer
Carcinoma, Pancreatic Ductal - pathology
Classification
Crohn's disease
Diagnosis
Fibrosis
Granulocytic epithelial lesion
Growth patterns
Heterotopic pancreas
Humans
Inflammatory bowel disease
Inflammatory bowel diseases
Leukocytes (neutrophilic)
Metaplasia
Neoplasia
Neuroendocrine tumors
Pancreas
Pancreas - pathology
Pancreatic Neoplasms - pathology
Pancreatitis
Patients
Small intestine
Steroids
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Summary:The diagnosis of type 2 autoimmune pancreatitis (AIP) is dependent on typical radiologic imaging and the presence of the granulocytic epithelial lesion (GEL), which is characterized by ductal neutrophilic infiltration with or without neutrophilic acinar infiltration. We evaluated GEL and related clinicopathologic factors in 165 resected heterotopic pancreata (HPs) [57 gastric (35%), 56 duodenal (34%), 30 omental (18%), and 22 jejunal (13%)] and 29 matched orthotopic pancreata routinely examined during surgery. GEL was noted in 8% (13/165) of HPs, including ductal epithelial (6/13, 46%) and intraluminal (8/13, 62%) neutrophilic infiltrations. However, there was no GEL in orthotopic pancreata. Abdominal pain was observed in 6 (46%) patients with GEL-positive HPs. GEL was more commonly observed in HPs having symptoms (p = 0.029), a larger size (p = 0.028), and an infiltrative growth pattern (p = 0.006). In addition, periductal lymphoplasmacytic infiltration and fibrosis (both p 
ISSN:1424-3903
1424-3911
DOI:10.1016/j.pan.2022.03.001