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Role of Endoscopic Ultrasonography-Guided Fine Needle Aspiration/Biopsy in the Diagnosis of Autoimmune Pancreatitis

Type 1 autoimmune pancreatitis (AIP) is histologically characterized by lymphoplasmacytic sclerosing pancreatitis (LPSP). Recently, the diagnostic yield of endoscopic ultrasonography-guided fine needle aspiration/biopsy (EUS-FNA/B) for AIP has been reported. However, its role in the diagnostic flow...

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Autores principales: Noguchi, Kensaku, Nakai, Yousuke, Mizuno, Suguru, Hirano, Kenji, Kanai, Sachiko, Suzuki, Yukari, Inokuma, Akiyuki, Sato, Tatsuya, Hakuta, Ryunosuke, Ishigaki, Kazunaga, Saito, Kei, Saito, Tomotaka, Hamada, Tsuyoshi, Takahara, Naminatsu, Kogure, Hirofumi, Isayama, Hiroyuki, Koike, Kazuhiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698022/
https://www.ncbi.nlm.nih.gov/pubmed/33203118
http://dx.doi.org/10.3390/diagnostics10110954
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author Noguchi, Kensaku
Nakai, Yousuke
Mizuno, Suguru
Hirano, Kenji
Kanai, Sachiko
Suzuki, Yukari
Inokuma, Akiyuki
Sato, Tatsuya
Hakuta, Ryunosuke
Ishigaki, Kazunaga
Saito, Kei
Saito, Tomotaka
Hamada, Tsuyoshi
Takahara, Naminatsu
Kogure, Hirofumi
Isayama, Hiroyuki
Koike, Kazuhiko
author_facet Noguchi, Kensaku
Nakai, Yousuke
Mizuno, Suguru
Hirano, Kenji
Kanai, Sachiko
Suzuki, Yukari
Inokuma, Akiyuki
Sato, Tatsuya
Hakuta, Ryunosuke
Ishigaki, Kazunaga
Saito, Kei
Saito, Tomotaka
Hamada, Tsuyoshi
Takahara, Naminatsu
Kogure, Hirofumi
Isayama, Hiroyuki
Koike, Kazuhiko
author_sort Noguchi, Kensaku
collection PubMed
description Type 1 autoimmune pancreatitis (AIP) is histologically characterized by lymphoplasmacytic sclerosing pancreatitis (LPSP). Recently, the diagnostic yield of endoscopic ultrasonography-guided fine needle aspiration/biopsy (EUS-FNA/B) for AIP has been reported. However, its role in the diagnostic flow of AIP is not fully elucidated. We retrospectively reviewed 53 consecutive patients who were suspected with AIP and underwent EUS-FNA/B. We evaluated the contribution of EUS-FNA/B to the diagnosis of AIP before considering response to steroid therapy among patients with diffuse enlargement of the pancreas and those with focal enlargement, respectively. Twenty-two patients showed diffuse pancreatic enlargement and 31 showed focal enlargement. The final diagnosis was definitive AIP in 32 patients, probable AIP in 2, possible AIP in 1, and mass-forming focal pancreatitis in 18. There was no change in diagnosis after EUS-FNA/B among patients with diffuse pancreatic enlargement, while diagnosis changed in 38.7% (12/31) among those with focal enlargement—there was a probable to definitive diagnosis in 4 patients, unspecified to definitive in 3, and unspecified to probable in 5. EUS-FNB provided a significantly higher sensitivity for typical pathological findings of LPSP than EUS-FNA, and 10 patients were diagnosed as pathologically definitive AIP by EUS-FNB, though none were by EUS-FNA (p = 0.002). EUS-FNA/B was useful in the diagnosis of focal type AIP, and steroid therapy could be introduced after the diagnosis was confirmed. Meanwhile, EUS-FNA/B provided no contribution to diagnosis of diffuse type AIP. EUS-FNB showed a higher diagnostic yield than FNA.
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spelling pubmed-76980222020-11-29 Role of Endoscopic Ultrasonography-Guided Fine Needle Aspiration/Biopsy in the Diagnosis of Autoimmune Pancreatitis Noguchi, Kensaku Nakai, Yousuke Mizuno, Suguru Hirano, Kenji Kanai, Sachiko Suzuki, Yukari Inokuma, Akiyuki Sato, Tatsuya Hakuta, Ryunosuke Ishigaki, Kazunaga Saito, Kei Saito, Tomotaka Hamada, Tsuyoshi Takahara, Naminatsu Kogure, Hirofumi Isayama, Hiroyuki Koike, Kazuhiko Diagnostics (Basel) Article Type 1 autoimmune pancreatitis (AIP) is histologically characterized by lymphoplasmacytic sclerosing pancreatitis (LPSP). Recently, the diagnostic yield of endoscopic ultrasonography-guided fine needle aspiration/biopsy (EUS-FNA/B) for AIP has been reported. However, its role in the diagnostic flow of AIP is not fully elucidated. We retrospectively reviewed 53 consecutive patients who were suspected with AIP and underwent EUS-FNA/B. We evaluated the contribution of EUS-FNA/B to the diagnosis of AIP before considering response to steroid therapy among patients with diffuse enlargement of the pancreas and those with focal enlargement, respectively. Twenty-two patients showed diffuse pancreatic enlargement and 31 showed focal enlargement. The final diagnosis was definitive AIP in 32 patients, probable AIP in 2, possible AIP in 1, and mass-forming focal pancreatitis in 18. There was no change in diagnosis after EUS-FNA/B among patients with diffuse pancreatic enlargement, while diagnosis changed in 38.7% (12/31) among those with focal enlargement—there was a probable to definitive diagnosis in 4 patients, unspecified to definitive in 3, and unspecified to probable in 5. EUS-FNB provided a significantly higher sensitivity for typical pathological findings of LPSP than EUS-FNA, and 10 patients were diagnosed as pathologically definitive AIP by EUS-FNB, though none were by EUS-FNA (p = 0.002). EUS-FNA/B was useful in the diagnosis of focal type AIP, and steroid therapy could be introduced after the diagnosis was confirmed. Meanwhile, EUS-FNA/B provided no contribution to diagnosis of diffuse type AIP. EUS-FNB showed a higher diagnostic yield than FNA. MDPI 2020-11-15 /pmc/articles/PMC7698022/ /pubmed/33203118 http://dx.doi.org/10.3390/diagnostics10110954 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Noguchi, Kensaku
Nakai, Yousuke
Mizuno, Suguru
Hirano, Kenji
Kanai, Sachiko
Suzuki, Yukari
Inokuma, Akiyuki
Sato, Tatsuya
Hakuta, Ryunosuke
Ishigaki, Kazunaga
Saito, Kei
Saito, Tomotaka
Hamada, Tsuyoshi
Takahara, Naminatsu
Kogure, Hirofumi
Isayama, Hiroyuki
Koike, Kazuhiko
Role of Endoscopic Ultrasonography-Guided Fine Needle Aspiration/Biopsy in the Diagnosis of Autoimmune Pancreatitis
title Role of Endoscopic Ultrasonography-Guided Fine Needle Aspiration/Biopsy in the Diagnosis of Autoimmune Pancreatitis
title_full Role of Endoscopic Ultrasonography-Guided Fine Needle Aspiration/Biopsy in the Diagnosis of Autoimmune Pancreatitis
title_fullStr Role of Endoscopic Ultrasonography-Guided Fine Needle Aspiration/Biopsy in the Diagnosis of Autoimmune Pancreatitis
title_full_unstemmed Role of Endoscopic Ultrasonography-Guided Fine Needle Aspiration/Biopsy in the Diagnosis of Autoimmune Pancreatitis
title_short Role of Endoscopic Ultrasonography-Guided Fine Needle Aspiration/Biopsy in the Diagnosis of Autoimmune Pancreatitis
title_sort role of endoscopic ultrasonography-guided fine needle aspiration/biopsy in the diagnosis of autoimmune pancreatitis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698022/
https://www.ncbi.nlm.nih.gov/pubmed/33203118
http://dx.doi.org/10.3390/diagnostics10110954
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