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Medline ® Abstract for Reference 36

of 'Autoimmune pancreatitis'

Diagnosis of autoimmune pancreatitis by EUS-FNA by using a 22-gauge needle based on the International Consensus Diagnostic Criteria.
Kanno A, Ishida K, Hamada S, Fujishima F, Unno J, Kume K, Kikuta K, Hirota M, Masamune A, Satoh K, Notohara K, Shimosegawa T
Gastrointest Endosc. 2012 Sep;76(3):594-602.
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.
DESIGN: A retrospective study.
SETTING: Single academic center.
PATIENTS: 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.
LIMITATIONS: 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.