title: EUS-FNA contribution in the identification of autoimmune pancreatitis: a case report.
abstract: BACKGROUND
  Autoimmune pancreatitis is a benign inflammatory disease of the pancreas which mimics pancreatic malignancy both clinically and radiologically. Autoimmune pancreatitis is presented as a diffuse enlargement of the pancreas and as a diffuse irregular narrowing of the main pancreatic duct.
  
  
  METHODS
  We report the endoscopic-ultrasound-guided (EUS-guided) fine needle aspiration (FNA) cytology features of a case with autoimmune pancreatitis. A 24-year-old woman with diabetes mellitus was admitted to our hospital after having painless jaundice for 15 days. She denied any alcohol consumption. The biochemical profile showed a marked elevation of bilirubin and hyperglycemia while gamma-GT and CA 19-9 levels were increased fivefold. The immunologic profile of the patient was negative. EUS revealed diffuse hypoechoic pancreatic enlargement (sausage-like appearance of the pancreas). EUS-FNA was performed and the smears were rich in inflammatory cells (mainly lymphoplasmacytes) with sparse epithelial cells lacking atypia, elements which show a strong correlation between the histopathological and cytological findings. The patient underwent steroid therapy which led to resolution of the clinical symptoms and imaging abnormalities within a month.
  
  
  CONCLUSIONS
  The FNA-cytology findings in conjunction with clinical and EUS findings could potentially establish a diagnosis of autoimmune pancreatitis and exclude carcinoma, thus preventing pancreatic resection.
authors.affiliation: Department of Cytology, Athens General Hospital, Athens, Greece.
authors.forename: Charitini
authors.initials: C
authors.lastname: Salla
authors.forename: Paschalis
authors.initials: P
authors.lastname: Chatzipantelis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Konstantinou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Karoumpalis
authors.forename: Akrivi
authors.initials: A
authors.lastname: Pantazopoulou
authors.forename: Grigorios
authors.initials: G
authors.lastname: Tsiotos
mesh_terms: D000328:Adult; D001327:Autoimmune Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D044963:Biopsy, Fine-Needle; D019160:Endosonography; D005260:Female; D006801:Humans; D010179:Pancreas / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology*; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000276:immunology* / Q000473:pathology*