| セッション情報 |
International Session3(消化器内視鏡学会・消化器病学会合同)
IgG4-related disease and endoscopy
|
| タイトル |
内IS3-9：EUS-FNA using a standard 19-gauge needle for the diagnosis of autoimmune pancreatitis
|
| 演者 |
T. Iwashita（First Department of Internal Medicine, Gifu University Hospital） |
| 共同演者 |
I. Yasuda（First Department of Internal Medicine, Gifu University Hospital）, H. Moriwaki（First Department of Internal Medicine, Gifu University Hospital） |
| 抄録 |
Background: In the diagnosis of autoimmune pancreatitis (AIP), histological evaluation of pancreatic lesion is important to distinguish AIP from pancreatic cancer and confirm the etiology of pancreatitis. EUS-FNA is a well-established technique to obtain pathological specimens from the pancreas. However, it is still unclear whether the amount of specimen obtained by EUS-FNA is sufficient for the histological diagnosis of AIP in which evaluation of tissue architecture and immunostaining are crucial. Aims: To evaluate the yield of EUS-FNA using a standard 19-gauge needle (19GN) for the histological diagnosis of AIP. Methods: Fifty-two patients who were clinically diagnosed with AIP and underwent EUS-FNA using 19GN between 2004 and 2011 were retrospectively identified on the EUS database. The FNA specimens were histologically evaluated. Histological diagnosis of AIP was made according to International Consensus Diagnostic Criteria (ICDC) for Autoimmune Pancreatitis. Results: The amount of FNA specimen was adequate for histological evaluation in 48 patients. Histological evaluation revealed periductal lymphoplasmacytic infiltrate without granulocytic infiltration in 28, obliterative phlebitis in 23, storiform fibrosis in 41, and abundant (>10/HPF) IgG4-positve cells in 9. According to ICDC, level 1 and level 2 criteria were fulfilled in 23 and 8 patients, respectively. Conclusion: EUS-FNA using 19GN is a reliable procedure to obtain histological samples from pancreatic lesions. On histological evaluation, either level 1 or level 2 criteria was fulfilled in 31 patients (60%). |
| 索引用語 |
AIP, EUS-FNA |
