Diagnosis of autoimmune pancreatitis by EUS-guided FNA using a 22-gauge needle: a prospective multicenter study

Abstract

Pancreatic tissues with at least 1 HPF were obtained by EUS-FNA from approximately 80% of patients, and nearly 60% of patients were diagnosed with ICDC level 2 or higher. Our findings indicate that EUS-FNA with a 22G needle may be useful for the histopathologic diagnosis of AIP. (Clinical trial registration number: UMIN000010097.).

Branch Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas Involving Type 1 Localized Autoimmune Pancreatitis with Normal Serum IgG4 Levels Successfully Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration and Treated without Pancreatic Surgery

“…In the report of Kanno et al (12), the percentage of the diagnostic ability of EUS-FNA for Level 1 LPSP and level 1 or 2 LPSP was 41% (32/78) and 57.7% (45/78) in 78 cases of suspected AIP, respectively, while in the report of Morishima et al (13), these respective values were 7.9% (3/38) and 65.8% (25/38) in 38 cases of definitive AIP. These findings indicate that level 2 or more LPSP can be diagnosed in almost 60% of patients with AIP in whom EUS-FNA has been performed, and that EUS-FNA can improve the diagnostic ability for AIP for many patients with AIP.…”

“…Recently, two multicenter prospective studies on the diagnostic ability of EUS-FNA using a 22-G needle for patients with suspected AIP have been reported (12,13). In the report of Kanno et al (12), the percentage of the diagnostic ability of EUS-FNA for Level 1 LPSP and level 1 or 2 LPSP was 41% (32/78) and 57.7% (45/78) in 78 cases of suspected AIP, respectively, while in the report of Morishima et al (13), these respective values were 7.9% (3/38) and 65.8% (25/38) in 38 cases of definitive AIP.…”

Endoscopic Ultrasonography‐Guided Fine Needle Aspiration Can Be Used to Rule Out Malignancy in Autoimmune Pancreatitis Patients

“…Henceforth, if pancreatic cancer patients are undiagnosed by EUS‐FNA, investigating the serum IgG4 level to rule out autoimmune pancreatitis is an important diagnostic tool. Third, our ability to diagnose autoimmune pancreatitis with EUS‐FNA was lower than past reports, because the primary aim of EUS‐FNA in autoimmune pancreatitis patients is to rule out malignancy in our hospital. Therefore, only cytology was performed in some of the autoimmune pancreatitis patients.…”

“…However, Imai et al were unable to histopathologically diagnose autoimmune pancreatitis using a 22‐G needle. Two multicenter studies found that the ability to diagnose EUS‐FNA was poor . In the only report written by Kanno et al that described favorable results, level 1 and 2 histological findings were observed in 56 and 24% of autoimmune pancreatitis patients, respectively, based on the ICDC by EUS‐FNA using 22‐G automated spring‐loaded PowerShot needles (Olympus Medical Systems, Tokyo, Japan).…”

[Eosinophilic pancreatitis and autoimmune pancreatitis: comparison, differential diagnosis, and treatment]

“…Per tale motivo la diagnosi viene posta dalla biopsia pancreatica. Un recente studio giapponese ha dimostrato che con la tecnica poco invasiva dell'agoaspirato sotto guida eco-endoscopica [50] è possibile pervenire a una diagnosi istopatologica molto accurata.…”