Endoscopic ultrasound-guided fine needle aspiration in the differentiation of type 1 and type 2 autoimmune pancreatitis

Takuya Ishikawa, Akihiro Itoh, Hiroki Kawashima, Eizaburo Ohno, Hiroshi Matsubara, Yuya Itoh, Yosuke Nakamura, Takeshi Hiramatsu, Masanao Nakamura, Ryoji Miyahara, Naoki Omiya, Hidemi Goto, Yoshiki Hirooka

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Abstract

AIM: To investigate the usefulness of endoscopic ultrasound- guided fine needle aspiration (EUS-FNA) in the differentiation of autoimmune pancreatitis (AIP). METHODS: We retrospectively reviewed 47 of 56 AIP patients who underwent EUS-FNA and met the Asian diagnostic criteria. On 47 EUS-FNA specimens, we evaluated the presence of adequate material and characteristic features of lymphoplasmacytic sclerosing pancreatitis (LPSP) and idiopathic duct-centric pancreatitis (IDCP) mentioned in the International Consensus Diagnostic Criteria and examined if these findings make a contribution to the differential diagnosis of type 1 and type 2 AIP. A disposable 22-gauge needle was used for EUS-FNA. RESULTS: Adequate specimens including pancreatic tissue for differentiating AIP from cancer were obtained from 43 of 47 patients who underwent EUSFNA. EUS-FNA was performed from the pancreatic head in 21 cases, which is known to be technically difficult when performed by core biopsy; there was no significant difference in the results compared with pancreatic body-tail. Nine of 47 patients met level 1 findings of LPSP and 5 patients met level 2 findings of LPSP. No one met level 1 findings of IDCP, but 3 patients met level 2 findings of IDCP. Of 10 seronegative cases, 2 cases were diagnosed with "definitive type 1 AIP", and 3 cases were diagnosed with "probable type 2 AIP" when considering both the level 2 histological findings and response to steroids. CONCLUSION: EUS-FNA is useful in the differentiation of type 1 and type 2 AIP, particularly in seronegative cases.

Original languageEnglish
Pages (from-to)3883-3888
Number of pages6
JournalWorld Journal of Gastroenterology
Volume18
Issue number29
DOIs
Publication statusPublished - 07-08-2012
Externally publishedYes

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Endoscopic Ultrasound-Guided Fine Needle Aspiration
Pancreatitis

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Ishikawa, Takuya ; Itoh, Akihiro ; Kawashima, Hiroki ; Ohno, Eizaburo ; Matsubara, Hiroshi ; Itoh, Yuya ; Nakamura, Yosuke ; Hiramatsu, Takeshi ; Nakamura, Masanao ; Miyahara, Ryoji ; Omiya, Naoki ; Goto, Hidemi ; Hirooka, Yoshiki. / Endoscopic ultrasound-guided fine needle aspiration in the differentiation of type 1 and type 2 autoimmune pancreatitis. In: World Journal of Gastroenterology. 2012 ; Vol. 18, No. 29. pp. 3883-3888.
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abstract = "AIM: To investigate the usefulness of endoscopic ultrasound- guided fine needle aspiration (EUS-FNA) in the differentiation of autoimmune pancreatitis (AIP). METHODS: We retrospectively reviewed 47 of 56 AIP patients who underwent EUS-FNA and met the Asian diagnostic criteria. On 47 EUS-FNA specimens, we evaluated the presence of adequate material and characteristic features of lymphoplasmacytic sclerosing pancreatitis (LPSP) and idiopathic duct-centric pancreatitis (IDCP) mentioned in the International Consensus Diagnostic Criteria and examined if these findings make a contribution to the differential diagnosis of type 1 and type 2 AIP. A disposable 22-gauge needle was used for EUS-FNA. RESULTS: Adequate specimens including pancreatic tissue for differentiating AIP from cancer were obtained from 43 of 47 patients who underwent EUSFNA. EUS-FNA was performed from the pancreatic head in 21 cases, which is known to be technically difficult when performed by core biopsy; there was no significant difference in the results compared with pancreatic body-tail. Nine of 47 patients met level 1 findings of LPSP and 5 patients met level 2 findings of LPSP. No one met level 1 findings of IDCP, but 3 patients met level 2 findings of IDCP. Of 10 seronegative cases, 2 cases were diagnosed with {"}definitive type 1 AIP{"}, and 3 cases were diagnosed with {"}probable type 2 AIP{"} when considering both the level 2 histological findings and response to steroids. CONCLUSION: EUS-FNA is useful in the differentiation of type 1 and type 2 AIP, particularly in seronegative cases.",
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Ishikawa, T, Itoh, A, Kawashima, H, Ohno, E, Matsubara, H, Itoh, Y, Nakamura, Y, Hiramatsu, T, Nakamura, M, Miyahara, R, Omiya, N, Goto, H & Hirooka, Y 2012, 'Endoscopic ultrasound-guided fine needle aspiration in the differentiation of type 1 and type 2 autoimmune pancreatitis', World Journal of Gastroenterology, vol. 18, no. 29, pp. 3883-3888. https://doi.org/10.3748/wjg.v18.i29.3883

Endoscopic ultrasound-guided fine needle aspiration in the differentiation of type 1 and type 2 autoimmune pancreatitis. / Ishikawa, Takuya; Itoh, Akihiro; Kawashima, Hiroki; Ohno, Eizaburo; Matsubara, Hiroshi; Itoh, Yuya; Nakamura, Yosuke; Hiramatsu, Takeshi; Nakamura, Masanao; Miyahara, Ryoji; Omiya, Naoki; Goto, Hidemi; Hirooka, Yoshiki.

In: World Journal of Gastroenterology, Vol. 18, No. 29, 07.08.2012, p. 3883-3888.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Endoscopic ultrasound-guided fine needle aspiration in the differentiation of type 1 and type 2 autoimmune pancreatitis

AU - Ishikawa, Takuya

AU - Itoh, Akihiro

AU - Kawashima, Hiroki

AU - Ohno, Eizaburo

AU - Matsubara, Hiroshi

AU - Itoh, Yuya

AU - Nakamura, Yosuke

AU - Hiramatsu, Takeshi

AU - Nakamura, Masanao

AU - Miyahara, Ryoji

AU - Omiya, Naoki

AU - Goto, Hidemi

AU - Hirooka, Yoshiki

PY - 2012/8/7

Y1 - 2012/8/7

N2 - AIM: To investigate the usefulness of endoscopic ultrasound- guided fine needle aspiration (EUS-FNA) in the differentiation of autoimmune pancreatitis (AIP). METHODS: We retrospectively reviewed 47 of 56 AIP patients who underwent EUS-FNA and met the Asian diagnostic criteria. On 47 EUS-FNA specimens, we evaluated the presence of adequate material and characteristic features of lymphoplasmacytic sclerosing pancreatitis (LPSP) and idiopathic duct-centric pancreatitis (IDCP) mentioned in the International Consensus Diagnostic Criteria and examined if these findings make a contribution to the differential diagnosis of type 1 and type 2 AIP. A disposable 22-gauge needle was used for EUS-FNA. RESULTS: Adequate specimens including pancreatic tissue for differentiating AIP from cancer were obtained from 43 of 47 patients who underwent EUSFNA. EUS-FNA was performed from the pancreatic head in 21 cases, which is known to be technically difficult when performed by core biopsy; there was no significant difference in the results compared with pancreatic body-tail. Nine of 47 patients met level 1 findings of LPSP and 5 patients met level 2 findings of LPSP. No one met level 1 findings of IDCP, but 3 patients met level 2 findings of IDCP. Of 10 seronegative cases, 2 cases were diagnosed with "definitive type 1 AIP", and 3 cases were diagnosed with "probable type 2 AIP" when considering both the level 2 histological findings and response to steroids. CONCLUSION: EUS-FNA is useful in the differentiation of type 1 and type 2 AIP, particularly in seronegative cases.

AB - AIM: To investigate the usefulness of endoscopic ultrasound- guided fine needle aspiration (EUS-FNA) in the differentiation of autoimmune pancreatitis (AIP). METHODS: We retrospectively reviewed 47 of 56 AIP patients who underwent EUS-FNA and met the Asian diagnostic criteria. On 47 EUS-FNA specimens, we evaluated the presence of adequate material and characteristic features of lymphoplasmacytic sclerosing pancreatitis (LPSP) and idiopathic duct-centric pancreatitis (IDCP) mentioned in the International Consensus Diagnostic Criteria and examined if these findings make a contribution to the differential diagnosis of type 1 and type 2 AIP. A disposable 22-gauge needle was used for EUS-FNA. RESULTS: Adequate specimens including pancreatic tissue for differentiating AIP from cancer were obtained from 43 of 47 patients who underwent EUSFNA. EUS-FNA was performed from the pancreatic head in 21 cases, which is known to be technically difficult when performed by core biopsy; there was no significant difference in the results compared with pancreatic body-tail. Nine of 47 patients met level 1 findings of LPSP and 5 patients met level 2 findings of LPSP. No one met level 1 findings of IDCP, but 3 patients met level 2 findings of IDCP. Of 10 seronegative cases, 2 cases were diagnosed with "definitive type 1 AIP", and 3 cases were diagnosed with "probable type 2 AIP" when considering both the level 2 histological findings and response to steroids. CONCLUSION: EUS-FNA is useful in the differentiation of type 1 and type 2 AIP, particularly in seronegative cases.

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