Diagnosis of autoimmune pancreatitis by EUS-FNA by using a 22-gauge needle based on the International Consensus Diagnostic Criteria.
BACKGROUND
It is controversial whether EUS-guided FNA by using 22-gauge (G) needles is useful for the diagnosis or evaluation of autoimmune pancreatitis (AIP).


OBJECTIVE
To evaluate the usefulness of EUS-FNA by 22-G needles for the histopathological diagnosis of AIP.


METHODS
A retrospective study.


METHODS
Single academic center.


METHODS
A total of 273 patients, including 25 with AIP, underwent EUS-FNA and histological examinations.


RESULTS
EUS-FNA by using 22-G needles provided adequate tissue samples for histopathological evaluation because more than 10 high-power fields were available for evaluation in 20 of 25 patients (80%). The mean immunoglobulin G4-positive plasma cell count was 13.7/high-power field. Obliterative phlebitis was observed in 10 of 25 patients (40%). In the context of the International Consensus Diagnostic Criteria for AIP, 14 and 6 of 25 patients were judged to have level 1 (positive for 3 or 4 items) and level 2 (positive for 2 items) histological findings, respectively, meaning that 20 of 25 patients were suggested to have lymphoplasmacytic sclerosing pancreatitis based on the International Consensus Diagnostic Criteria. The diagnosis in 1 patient was type 2 AIP because a granulocytic epithelial lesion was identified in this patient.


CONCLUSIONS
A retrospective study with a small number of patients.


CONCLUSIONS
The results of this study suggest that EUS-FNA by using 22-G needles provides tissue samples adequate for histopathological evaluation and greatly contributes to the histological diagnosis of AIP.
Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Atsushi
A
Kanno
Kazuyuki
K
Ishida
Shin
S
Hamada
Fumiyoshi
F
Fujishima
Jun
J
Unno
Kiyoshi
K
Kume
Kazuhiro
K
Kikuta
Morihisa
M
Hirota
Atsushi
A
Masamune
Kennichi
K
Satoh
Kenji
K
Notohara
Tooru
T
Shimosegawa
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D051997:ADP-ribosyl Cyclase 1 / Q000378:metabolism; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000473:pathology; D044963:Biopsy, Fine-Needle / Q000295:instrumentation; D002452:Cell Count; D019160:Endosonography; D007074:Immunoglobulin G / Q000378:metabolism; D015588:Observer Variation; D010179:Pancreas / Q000473:pathology; D010195:Pancreatitis / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D010689:Phlebitis / Q000175:diagnosis; D010950:Plasma Cells / Q000378:metabolism; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional; D003245:Consensus Statements as Topic
D051997:ADP-ribosyl Cyclase 1; D007074:Immunoglobulin G