Mitsuru Sugimoto 1 , Tadayuki Takagi 2 , Rei Suzuki 1 , Naoki Konno 1 , Hiroyuki Asama 1 , Yuki Sato 1 , Hiroki Irie 1 , Ko Watanabe 1 , Jun Nakamura 1 , Hitomi Kikuchi 1 , Mika Takasumi 1 , Minami Hashimoto 1 , Tsunetaka Kato 1 , Takuto Hikichi 3 , Kenji Notohara 4 , Hiromasa Ohira 1 Show Affiliations »
Abstract
BACKGROUND: Other than surgery, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the only procedure for histologically diagnosing autoimmune pancreatitis (AIP). However, adequate specimens are difficult to obtain. Recently, more adequate specimens were reported to be obtained with EUS-FNA with a wet suction technique (WEST) than with conventional EUS-FNA. AIM: To histologically diagnose AIP by EUS-FNA with a WEST. METHODS: Eleven patients with possible type 1 AIP between February 2016 and August 2018 underwent EUS-FNA with a WEST (WEST group), with four punctures by 19 or 22 G needles. As a historical control, 23 type 1 AIP patients who underwent no fewer than four punctures with 19 or 22 G needles were enrolled (DRY group). Patient characteristics and histological findings were compared between the two groups. RESULTS: Three histopathological factors according to the International Consensus Diagnostic Criteria were significantly greater in the WEST group than the DRY group [lymphoplasmacytic infiltrate without granulocytic infiltration: 9 (81.8%) vs 6 (26.1%), P = 0.003, storiform fibrosis: 5 (45.5%) vs 1 (4.3%), P = 0.008, abundant (> 10 cells/HPF) IgG4-positive cells: 7 (63.6%) vs 5 (21.7%), P = 0.026]. Level 1 or level 2 histopathological findings were observed more often in the WEST group than in the DRY group [8 (72.7%) vs 3 (13.0%), P = 0.001]. CONCLUSION: EUS-FNA with a WEST was more successful than standard EUS-FNA in histologically diagnosing AIP. ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
BACKGROUND: Other than surgery, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the only procedure for histologically diagnosing autoimmune pancreatitis (AIP ). However, adequate specimens are difficult to obtain. Recently, more adequate specimens were reported to be obtained with EUS-FNA with a wet suction technique (WEST) than with conventional EUS-FNA. AIM: To histologically diagnose AIP by EUS-FNA with a WEST. METHODS: Eleven patients with possible type 1 AIP between February 2016 and August 2018 underwent EUS-FNA with a WEST (WEST group), with four punctures by 19 or 22 G needles. As a historical control, 23 type 1 AIP patients who underwent no fewer than four punctures with 19 or 22 G needles were enrolled (DRY group). Patient characteristics and histological findings were compared between the two groups. RESULTS: Three histopathological factors according to the International Consensus Diagnostic Criteria were significantly greater in the WEST group than the DRY group [lymphoplasmacytic infiltrate without granulocytic infiltration: 9 (81.8%) vs 6 (26.1%), P = 0.003, storiform fibrosis : 5 (45.5%) vs 1 (4.3%), P = 0.008, abundant (> 10 cells/HPF) IgG4-positive cells: 7 (63.6%) vs 5 (21.7%), P = 0.026]. Level 1 or level 2 histopathological findings were observed more often in the WEST group than in the DRY group [8 (72.7%) vs 3 (13.0%), P = 0.001]. CONCLUSION: EUS-FNA with a WEST was more successful than standard EUS-FNA in histologically diagnosing AIP . ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Entities: Disease
Species
Keywords:
Autoimmune pancreatitis; Endoscopic ultrasound-guided fine needle aspiration; Wet suction technique
Year: 2020
PMID： 31970173 PMCID： PMC6962058 DOI： 10.12998/wjcc.v8.i1.88
Source DB: PubMed Journal: World J Clin Cases ISSN： 2307-8960 Impact factor: 1.337