Use of Samples From Endoscopic Ultrasound–Guided 19-Gauge Fine-Needle Aspiration in Diagnosis of Autoimmune Pancreatitis

Iwashita, Takuji; Yasuda, Ichiro; Doi, Shinpei; Ando, Nobuhiro; Nakashima, Masanori; Adachi, Seiji; Hirose, Yoshinobu; Mukai, Tsuyoshi; Iwata, Koichi; Tomita, Eiichi; Itoi, Takao; Moriwaki, Hisataka

doi:10.1016/j.cgh.2011.09.032

Cited by 164 publications

(116 citation statements)

References 32 publications

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“…Az EUH-FNA a PDCA diagnosztikájában kitűnő mód-szer, azonban többnyire a kis mennyiségű minta miatt AIP igazolása ezzel a módszerrel nehéz [6,40,41,42,43,44]. AIP szövettani diagnosztikájában viszonylag kis esetszámú (n = 14-44) retrospektív tanulmányok alapján Trucut biopsia vagy vastagabb FNA-tűk (22, 19 G) hasznosabbak [38,45,46,47].…”

Section: áBraunclassified

Autoimmune pancreatitis.Evidence based management guidelines of the Hungarian Pancreatic Study Group

et al. 2015

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Az autoimmun pancreatitis ritka megbetegedés, amely megjelenésében akár hasnyálmirigy-daganatot utánozhat, azonban ez utóbbival ellentétben nem műtéti, hanem gyógyszeres kezelést igényel. A betegség korrekt diagnózisa, differenciáldiagnosztikája és a betegek megfelelő kezelése korszerű és bizonyítékokon alapuló kezelési útmutatót igényel. A Magyar Hasnyálmirigy Munkacsoport célul tűzte ki, hogy a jelenleg elérhető nemzetközi irányvonalakat, illetve evidenciákat alapul véve az autoimmun pancreatitis kezelésének kulcskérdései vonatkozásában bizonyítékalapú irány-elveket fogalmazzon meg. A Magyar Hasnyálmirigy Munkacsoport által kijelölt előkészítő és konzulens munkacsoport lefordította, és ahol szükségesnek találta, kiegészítette és/vagy módosította a nemzetközi irányelveket. Összesen 4 témakörben (Alapok, Diagnózis, Differenciáldiagnosztika, Terápia) 29 releváns kérdést állított össze. Az evidencia osztályozását az UpToDate ® rendszere alapján határozta meg. Az összeállított irányelvek a 2014. szeptember 12-ei konszenzustalálkozón kerültek bemutatásra és megvitatásra. A résztvevők minden kérdést csaknem teljes (95% feletti) egyetértéssel fogadtak el. A Magyar Hasnyálmirigy Munkacsoport kezelési irányelvei az első, bizonyíték alapján ké-szült autoimmun pancreatitis kezelési útmutató hazánkban. Az irányelv komoly segítséget nyújthat az autoimmun pancreatitis oktatásához, a mindennapi betegellátáshoz és a megfelelő fi nanszírozás kialakításához. Ezért a szerzők bíznak abban, hogy ezen irányelvek minél szélesebb körben alapreferenciaként fognak szolgálni Magyarországon. Orv. Hetil., 2015, 156(8), 292-307.Kulcsszavak: bizonyítékon alapuló orvoslás, kezelési irányelvek, autoimmun pancreatitis Autoimmune pancreatitis Evidence based management guidelines of the Hungarian Pancreatic Study GroupAutoimmune pancreatitis is a rare disease which can even mimic pancreatic tumor, however, unlike the latter, it requires not surgical but conservative management. Correct diagnosis and differential diagnosis of autoimmune pancreatitis and treatment of these patients requires up-to-date and evidence based management guidelines. The Hun-

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Section: áBraunclassified

Autoimmune pancreatitis.Evidence based management guidelines of the Hungarian Pancreatic Study Group

et al. 2015

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“…FNA commonly yields small specimen samples and results in a loss of tissue architecture, making its interpretation challenging. Even EUS-guided FNA using a 19-gauge needle for histological review was only able to achieve a diagnosis of AIP in 43% of patients (24).…”

Section: Endoscopic Ultrasound-guided Tissue Acquisitionmentioning

confidence: 99%

EUS in the Diagnosis of Autoimmune Pancreatitis

Fujii

Levy

The Pancreapedia: Exocrine Pancreas Knowledge Base

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“…This unique histological subtype could be distinguished from type 1 AIP by expert pathologists with high diagnostic ratio (concordances: 60%-100%, multirater kappa: 0.54) using the international consensus histopathological diagnostic criteria [28] . The feasibility of arriving at a histological diagnosis for AIP using endoscopically obtained tissue samples has been argued [59][60][61][62] . Several studies demonstrated that tissue samples obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) enabled histological diagnosis of both type 1 [60][61][62] and type 2 [63,64] AIP.…”

Section: Histology Of the Pancreatic Lesionmentioning

confidence: 99%

“…The feasibility of arriving at a histological diagnosis for AIP using endoscopically obtained tissue samples has been argued [59][60][61][62] . Several studies demonstrated that tissue samples obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) enabled histological diagnosis of both type 1 [60][61][62] and type 2 [63,64] AIP. Figure 2 Algorithm of international consensus diagnostic criteria to diagnose type 1 autoimmune pancreatitis in subjects presenting with obstructive jaundice and/or pancreatic mass.…”

Section: Histology Of the Pancreatic Lesionmentioning

confidence: 99%

“…Today, the diagnosis of pancreatic mass lesions by EUS-FNA provides a sensitivity for detecting PC tissue that exceeds 90% (91%-93%) [59,65,66] , making EUS-FNA the most effective tool for excluding pancreatic malignancies. However, core biopsy using a large-caliber needle [60,61,67] may increase the chance of a definitive histological diagnosis of AIP. A Japanese nationwide survey published in 2012 [68] reported that histological confirmation was obtained in about 40% of AIP cases by EUS-guided tissue sampling, in 22% by resection, and in 18% by percutaneous biopsy.…”

Section: Exclusion Of the Pancreatobiliary Malignanciesmentioning

confidence: 99%

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Diagnosis Autoimmune Pancreatitis

Hart¹,

Chari²

The Pancreapedia: Exocrine Pancreas Knowledge Base

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Autoimmune pancreatitis (AIP) is a distinct form of chronic pancreatitis that is increasingly being reported. The presentation and clinical image findings of AIP sometimes resemble those of several pancreatic malignancies, but the therapeutic strategy differs appreciably. Therefore, accurate diagnosis is necessary for cases of AIP. To date, AIP is classified into two distinct subtypes from the viewpoints of etiology, serum markers, histology, other organ involvements, and frequency of relapse: type 1 is related to IgG4 (lymphoplasmacytic sclerosing pancreatitis) and type 2 is related to a granulocytic epithelial lesion (idiopathic duct-centric chronic pancreatitis). Both types of AIP are characterized by focal or diffuse pancreatic enlargement accompanied with a narrowing of the main pancreatic duct, and both show dramatic responses to corticosteroid. Unlike type 2, type 1 is characteristically associated with increasing levels of serum IgG4 and positive serum autoantibodies, abundant infiltration of IgG4-positive plasmacytes, frequent extrapancreatic lesions, and relapse. These findings have led several countries to propose diagnostic criteria for AIP, which consist of essentially similar diagnostic items; however, several differences exist for each country, mainly due to differences in the definition of AIP and the modalities used to diagnose this disease. An attempt to unite the diagnostic criteria worldwide was made with the publication in 2011 of the international consensus diagnostic criteria for AIP, established at the 2010 Congress of the International Association of Pancreatology (IAP).

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Use of Samples From Endoscopic Ultrasound–Guided 19-Gauge Fine-Needle Aspiration in Diagnosis of Autoimmune Pancreatitis

Cited by 164 publications

References 32 publications

Autoimmune pancreatitis.Evidence based management guidelines of the Hungarian Pancreatic Study Group

Autoimmune pancreatitis.Evidence based management guidelines of the Hungarian Pancreatic Study Group

EUS in the Diagnosis of Autoimmune Pancreatitis

Diagnosis Autoimmune Pancreatitis

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