Clinical significance of hypoechoic submandibular gland lesions in type 1 autoimmune pancreatitis

Table 1 Patient characteristics n (%)

Characteristics	Value (n = 37)
Female sex	22 (60)
Age, median (range)	68 (48-81)
Enlargement of the pancreas
Diffuse	21 (57)
Segmental	16 (43)
Irregular narrowing of the MPD by ERP
Diffuse	23 (62)
Segmental	7 (19)
NA	7 (19)
Serum IgG4 (mg/dL), median (range)	462 (3-2870)

MPD: Main pancreatic duct; NA: Not available; ERP: Endoscopic retrograde pancreatography.

Table 2 Impact of corticosteroid administration on ultrasonographic findings in submandibular glands

	Pre-Tx(n = 18)	Post-Tx(n = 18)	P value
Thickness of SGs (mm), mean ± SD	16.1 ± 4.2	13.5 ± 3.5	0.002
Echogenicity of SGs
Homogenous	2	3
Multiple hypoechoic lesions	16	2
Obscured hypoechoic lesions		13

SGs: Submandibular glands; pre/post-Tx: Pre/post-treatment by corticosteroids.

Table 3 Difference in sensitivity among diagnostic methods for sialadenitis n (%)

	Examined cases	Positive examination
SG swelling on physical examination	33	15 (46)
Ga accumulation in SGs by scintigraphy	25	7 (28)
Increased thickness in SGs by US (≥ 15 mm)	37	18 (49)
Multiple hypoechoic lesions in SGs by US	37	31 (84)
Multiple hypoechoic lesions in parotid glands by US	36	5 (14)

Ga: Gallium-67; SG: Submandibular glands; US: Ultrasonography.

Table 4 Other organ involvement

	n
Level 1 findings
IgG4-related SC	4
Retroperitoneal fibrosis	5
Level 2 findings
Enlarged salivary glands	20
Sialadenitis by SGUS	31
Renal involvement	4
Final diagnosis of OOI
Level 1	8
Level 2	18
Level 2 by SGUS	25

SC: Sclerosing cholangitis; SGUS: Ultrasonography of submandibular glands; OOI: Other organ involvement.

Table 5 Classification of primary diagnosis for type 1 autoimmune pancreatitis

Primary basis for diagnosis	Final diagnosis	Definitive diagnosis without OOI	Definitive diagnosis with OOI	Definitive diagnosis with SGUS
Histology	1	1
Typical imaging	21	19	1	1
Indeterminate imaging	8	8
Response to steroid	7	6		1

OOI: Other organ involvement; SGUS: Ultrasonography of submandibular glands.