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IS3-10:

The diagnosis of autoimmune pancreatitis by EUS-FNA based on the International Consensus Diagnostic Criteria (ICDC).

演者 A. Kanno(Division of Gastroenterology, Tohoku University Graduate School of Medicine)
共同演者 A. Masamune(Division of Gastroenterology, Tohoku University Graduate School of Medicine), T. Shimosegawa(Division of Gastroenterology, Tohoku University Graduate School of Medicine)
抄録 Background: It is controversial whether EUS-FNA is useful for the diagnosis of autoimmune pancreatitis (AIP). Objective: To evaluate the usefulness of EUS-FNA in the histopathological diagnosis of AIP.Design: A single-center retrospective study.Patients: Histopathological examination was performed on pancreatic specimens obtained from 378 patients including 34 with AIP by EUS-FNA. Results: EUS-FNA using a 22- or 19-G needle provided adequate tissue samples for histopathological evaluation; more than 10 high power fields (HPFs) were available for evaluation in 29 of 34 (85 %) patients. The mean CD38-positive plasma cell count was 65.1/HPF. The mean IgG4-positive plasma cell count was 22.2 /HPF. Obliterative phlebitis was observed in 17 of the 34 (50 %) patients. In the context of the International Consensus Diagnostic Criteria for AIP, 22 of 34 patients were level 1 (positive for 3 or 4 items), and 6 patients were level 2 (positive for 2 items). Collectively, 28 of 34 patients had lymphoplasmacytic sclerosing pancreatitis based on the ICDC. One patient was diagnosed with type 2 AIP since a granulocyte epithelial lesion was identified. Conclusions: EUS-FNA provides tissue samples that are adequate for histopathological evaluation, contributing to the histological diagnosis of AIP.
索引用語 AIP, ICDC