Autoimmune pancreatitis (AIP) is a chronic inflammation of the pancreas that can be treated with
steroids. It is a relatively newly recognized disease.
AIP can closely resemble pancreatic
cancer, but these two diseases require distinctly different courses of
tissue specimens from the pancreas is necessary for diagnosis and
subsequent treatment. Previously, specimens obtained using endoscopic
ultrasound-guided fine needle aspiration (EUS-FNA) have proven
inadequate because of the small sample size that can be procured via
‘Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) with a 22-gauge needle may be useful for the diagnosis of autoimmune pancreatitis (AIP) through microscopic examination of tissue samples.’
A new study suggests that an endoscopic procedure using a
larger-gauge needle may offer a solution for making this important
The study, "Diagnosis of autoimmune pancreatitis
by EUS-guided FNA using a 22-gauge needle: a prospective multicenter
study," is published in the November issue of GIE: Gastrointestinal Endoscopy
, the monthly, peer-reviewed journal of the American Society for Gastrointestinal Endoscopy (ASGE).
Based on imaging characteristics suggesting AIP, 78 patients were
selected for the innovative EUS-FNA procedure over a 13-month period.
Tissue samples were evaluated for sampling conditions, certain elevated
plasma cell counts indicating AIP, storiform fibrosis (a pattern of
scarring) and obliterative phlebitis (vein inflammation).
Tissue specimens were obtained from 62 patients, and features
indicative of AIP were identified in 45 of these. Therefore, 45 of 78
patients (58%) could be diagnosed with AIP according to
International Consensus Diagnostic Criteria.
The authors concluded that EUS-FNA with a 22-gauge needle may be
useful for the diagnosis of AIP through microscopic examination of