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Utility of endoscopic ultrasound-guided fine-needle biopsy in the diagnosis of type 1 autoimmune pancreatitis *
- Source :
- Endoscopy International Open, Endoscopy International Open, Vol 08, Iss 12, Pp E1855-E1861 (2020)
- Publication Year :
- 2020
- Publisher :
- Georg Thieme Verlag KG, 2020.
-
Abstract
- Background and study aims Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) performs poorly in the histological diagnosis of type 1 autoimmune pancreatitis (AIP). The aim of this study was to assess the performance of fine-needle biopsy (FNB) comparing reverse bevel (RB) and fork-tip (FT) needles. Patients and methods A retrospective study of prospectively maintained databases was performed. Patients with a final diagnosis of type 1 AIP who underwent EUS-FNB during diagnostic workup were included. Pathology reports were reviewed and classified as per international consensus diagnostic criteria (ICDC). The Primary outcome was EUS-FNB sensitivity in diagnosing type 1 AIP. Results Between March 2011 and December 2018, 24 patients with a final diagnosis of type 1 AIP underwent FNB. Six patients underwent biopsy with the RB needle and 18 with the FT needle. Mean age (± SD) 62.2 (± 11.4), 17 (70.8 %) male. No RB samples were diagnostic compared to 14 (78 %) FT; P = 0.001; of which 13 (72 %) were level 1. In eight (44 %) of FT cases a diagnosis was not possible without histology. Initial biopsy was diagnostic in five (62.5 %) of these cases. Including repeat biopsy, seven (87 %) had a diagnosis made by FT needle. Obliterative phlebitis (44 %) was the least frequently identified pathological feature and immunoglobulin (IgG)4 + plasma cells > 10 per high power field (78 %) the most common. Conclusion The FT needle demonstrated good performance for diagnosing type 1 AIP. The results support the preferential use of this core biopsy needle for EUS pancreatic tissue sampling.
- Subjects :
- Endoscopic ultrasound
medicine.medical_specialty
Original article
medicine.diagnostic_test
business.industry
Ultrasound
Histology
Retrospective cohort study
medicine.disease
03 medical and health sciences
0302 clinical medicine
030220 oncology & carcinogenesis
Biopsy
medicine
lcsh:Diseases of the digestive system. Gastroenterology
030211 gastroenterology & hepatology
Pharmacology (medical)
Sampling (medicine)
Radiology
lcsh:RC799-869
business
High-power field
Autoimmune pancreatitis
Subjects
Details
- Language :
- English
- ISSN :
- 21969736 and 23643722
- Volume :
- 8
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Endoscopy International Open
- Accession number :
- edsair.doi.dedup.....c70f45218ad20773b83434a6cac1b61f