Histological diagnosis of autoimmune pancreatitis using EUS-guided trucut biopsy: a comparison study with EUS-FNA

Mizuno, Nobumasa; Bhatia, Vikram; Hosoda, Waki; Sawaki, Akira; Hoki, Noriyuki; Hara, Kazuo; Takagi, Tadayuki; Ko, Shigeru B. H.; Yatabe, Yasushi; Goto, Hidemi; Yamao, Kenji

doi:10.1007/s00535-009-0062-6

Cited by 203 publications

(123 citation statements)

References 30 publications

(43 reference statements)

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“…While EUS findings of lymph node swelling and vascular invasion are typically associated with pancreatic cancer, it is sometimes difficult to distinguish between the two conditions, and EUS-FNA may be required [112]. EUS-FNA is an excellent diagnostic tool for discounting pancreatic cancer due to its high specificity (98-100 %), but it cannot provide a definitive diagnosis of AIP due to the small sample volume [113][114][115].…”

Section: (Level Of Recommendation: B)mentioning

confidence: 99%

“…While periductal lymphoplasmacytic infiltrates and obstructive phlebitis are characteristic findings for AIP, these are rarely found in biopsy specimens, and histological diagnosis using biopsy specimens is difficult [116]. A few reports showed clear significance of EUS-FNA in the histological diagnosis of AIP [115,117]. Conversely, EUS TruCut biopsy with IgG4 immunostaining was reported to be useful for the diagnosis of AIP [115,117].…”

Section: (Level Of Recommendation: B)mentioning

confidence: 99%

“…A few reports showed clear significance of EUS-FNA in the histological diagnosis of AIP [115,117]. Conversely, EUS TruCut biopsy with IgG4 immunostaining was reported to be useful for the diagnosis of AIP [115,117].…”

Section: (Level Of Recommendation: B)mentioning

confidence: 99%

See 2 more Smart Citations

Amendment of the Japanese Consensus Guidelines for Autoimmune Pancreatitis, 2013 II. Extrapancreatic lesions, differential diagnosis

et al. 2014

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Section: (Level Of Recommendation: B)mentioning

confidence: 99%

Section: (Level Of Recommendation: B)mentioning

confidence: 99%

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Amendment of the Japanese Consensus Guidelines for Autoimmune Pancreatitis, 2013 II. Extrapancreatic lesions, differential diagnosis

et al. 2014

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“…The image obtained by CT, showing the focal or dispersed organ enlargement without Wirsung's duct broadening, lack of calcifications or pseudocysts and enlarged gland ("sausage-shaped") with hypoechoic, patchy, heterogenous-looking parenchyma suggest autoimmune inflammation. The basic function of EUS usage in this case is EUS-FNA [15].…”

Section: Focal Pancreatic Changesmentioning

confidence: 99%

The role of endoscopic ultrasonography (EUS) in contemporary diagnosis of gastrointestinal diseases

Kiełtucki¹,

Wawrzyniec²

2016

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Day by day endoscopic ultrasonography (EUS) is becoming an essential diagnostic method for the assessment of solid lesions of the pancreas, cysts, pseudocysts and cystic tumours of the pancreas, enlarged mediastinal lymph nodes, staging of gastric cancer and rectal cancer, as well as lung or subepithelial tumours in the gastrointestinal tract. The ability to use this diagnostic method presents many challenges for performing specialists, from the organisation of the EUS surgery to maintaining its activity in a proper technical aspect, as well as the continuous improvement of staff qualifications. Endoscopic ultrasonography has revolutionised the practical aspects of gastroenterological practice and oncology. Particularly, EUS-guided fine-needle aspiration biopsy (EUS-FNA) of various pathologies in the gastrointestinal tract has provided invaluable effects and opportunities. This technique is becoming more and more available in Poland, creating a unique challenge to its practice. StreszczenieUltrasonografia endoskopowa (EUS) staje się z dnia na dzień kluczową metodą diagnostyczną zmian litych w trzustce, torbieli, pseudotorbieli i guzów torbielowatych trzustki, powiększonych węzłów chłonnych śródpiersia, zaawansowania raka żołądka, odbytnicy, jak również nowotworów płuc i zmian podnabłonkowych w przewodzie pokarmowym. Technika ta stawia przed wykonującymi badanie wiele wyzwań -zorganizowanie pracowni EUS, utrzymanie jej działania na należytym poziomie technicznym czy stałe podnoszenie kwalifikacji personelu. Ultrasonografia endoskopowa zrewolucjonizowała praktyczne aspekty diagnostyki gastroenterologicznej i onkologicznej, zwłaszcza biopsja cienkoigłowa kontrolowana ultrasonografią endoskopową (EUS-FNA) różnego rodzaju zmian w obrębie przewodu pokarmowego daje nieocenione efekty i możliwości. Metoda ta jest coraz bardziej dostępna w Polsce, zwiększają się również możliwości jej praktycznego doskonalenia.

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“…EUS-guided biopsies using large core biopsy needles can be used to obtain histological specimens for the diagnosis of autoimmune pancreatitis. Demonstration of the typical lymphoplasmacytic infiltrate has been proven to be possible and safe with EUS guided biopsies using the TruCut needle (Quick-Core®) (83,84). However, histological diagnosis of autoimmune pancreatitis is extremely difficult (even using Tru-cut or Procore TM needle) and diagnosis with EUS-FNA cytology needles is almost impossible.…”

Section: Differential Diagnosis Of Focal Autoimmune Pancreatitismentioning

confidence: 99%

The role of endoscopic ultrasound (EUS) in relation to other imaging modalities in the differential diagnosis between mass forming chronic pancreatitis, autoimmune pancreatitis and ductal pancreatic adenocarcinoma

Iglesias‐García

Lindkvist

Lariño‐Noia³

et al. 2012

Rev. esp. enferm. dig.

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Differential diagnosis of solid pancreatic lesions remains as an important clinical challenge, mainly for the differentiation between mass forming chronic pancreatitis, autoimmune pancreatitis and pancreatic adenocarcinoma. Endoscopic ultrasound (EUS), computed tomography (CT) and magnetic resonance imaging (MRI) can all provide valuable and complementary information in this setting. Among them, EUS has the unique ability to obtain specimens for histopathological diagnosis and can therefore play a crucial role in the evaluation patients with inconclusive findings on initial examinations. Nowadays, new developed techniques associated to EUS, like elastography and contrast enhancement, have shown promising results for the differential diagnosis of these pancreatic lesions.Key words: Endoscopic ultrasound. CT scan. MRI. Pancreatic tumors. INTRODUCTIONDifferential diagnosis of solid pancreatic masses remains a challenge, despite recent advances in different diagnostic procedures. In this article, the role of endoscopic ultrasound (EUS) including EUS-guided FNA, elastography and contrast enhancement will be reviewed in relation to computer tomography (CT), magnetic resonance tomography (MRI) and magnetic resonance cholangiopancreatography (MRCP). Differential diagnosis between malignant lesions and mass-forming chronic pancreatitis or focal autoimmune pancreatitis will be discussed. Tumor staging and evaluation of resectability of these pancreatic lesions will not be evaluated. Other imaging techniques, like PET-scan or octreoscan will not be analyze, because their usefulness in this context is unclear.Differential diagnosis between malignant pancreatic lesions (pancreatic cancer, pancreatic metastasis) and massforming chronic pancreatitis CT scan is the most widely spread imaging modality for evaluation of pancreatic solid masses and considered as the most comprehensive tool for diagnosis and surgical staging of pancreatic malignancies (1). CT technology has significantly advanced over the last years, multidetector helical CT scan allows for very thin sliced cuts, providing a higher image resolution and faster image acquisition (Fig. 1) Vol. 104. N.° 6, pp. 315-321, 2012 Disclosures: Dr. Julio Iglesias-García is international advisor of Cook-Medical. Dr. J. Enrique Domínguez-Muñoz is international advisor of Pentax Medical Company.Received: 27-03-201227-03- Accepted: 20-04-2012 Correspondence: Julio Iglesias-García. Department of Gastroenterology.

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Histological diagnosis of autoimmune pancreatitis using EUS-guided trucut biopsy: a comparison study with EUS-FNA

Abstract: EUS-TCB is a safe and accurate procedure for obtaining a histological diagnosis in patients with suspected AIP. EUS-TCB can serve as a rescue technique in cases of AIP lacking typical findings.

Cited by 203 publications

References 30 publications

Amendment of the Japanese Consensus Guidelines for Autoimmune Pancreatitis, 2013 II. Extrapancreatic lesions, differential diagnosis

Amendment of the Japanese Consensus Guidelines for Autoimmune Pancreatitis, 2013 II. Extrapancreatic lesions, differential diagnosis

The role of endoscopic ultrasonography (EUS) in contemporary diagnosis of gastrointestinal diseases

The role of endoscopic ultrasound (EUS) in relation to other imaging modalities in the differential diagnosis between mass forming chronic pancreatitis, autoimmune pancreatitis and ductal pancreatic adenocarcinoma

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