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Tsutsumi, Koichiro Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID Kaken ID researchmap
Ueki, Toru Departments of Internal Medicine, Fukuyama City Hospital
Noma, Yasuhiro Department of Internal Medicine, National Hospital Organization Fukuyama Medical Center
Omonishi, Kunihiro Departments of Internal Medicine and Pathology, Fukuyama City Hospital
Ohno, Kyotaro Departments of Internal Medicine and Pathology, Fukuyama City Hospital
Kawahara, Soichiro Departments of Internal Medicine, Fukuyama City Hospital
Oda, Takashi Departments of Internal Medicine, Fukuyama City Hospital
Kato, Hironari Department of Gastroenterology and Hepatology, Okayama University Hospital ORCID Kaken ID researchmap
Okada, Hiroyuki Department of Gastroenterology and Hepatology, Okayama University Hospital Kaken ID publons researchmap
Abstract
Background
The histological diagnosis of autoimmune pancreatitis (AIP) by an endoscopic ultrasound (EUS)-guided approach is still challenging.
Methods
We investigated the utility of the 21-gauge Menghini-type biopsy needle with the rolling method for the histological diagnosis of AIP, in comparison with conventional 22-gauge needles. Among total 28 patients, rate of definitive histological diagnosis, acquired sample area of tissue, rate of histopathological diagnosis of AIP, and adverse events were retrospectively analyzed.
Results
Definitive histological diagnoses were successfully accomplished in all 14 patients (100%) treated with a Menghini-type needle, and in 57% of cases (8/14) treated with conventional 22-gauge needles (P < 0.001). The median sample area of the tissue, except for blood contamination, was remarkably larger by the Menghini-type needle than by conventional-type needles (6.2 [IQR, 4.5–8.8] versus 0.7 [IQR, 0.2–2.0] mm2, P < 0.001), and the area per punctures was approximately 4 times larger (1.4 [IQR: 0.9–2.9] versus 0.3 [IQR: 0.1–0.6] mm2/puncture, P < 0.001). Based on the International Consensus Diagnostic Criteria, lymphoplasmacytic infiltration, abundant IgG4-postive cells, storiform fibrosis, and obliterative phlebitis were found in 86%/29%, 64%/0%, 36%/0%, and 7%/0% patients who were treated with the Menghini-type needle and conventional-type needles, respectively. Consequently, histopathological diagnosis with type 1 AIP (lever 1 or 2) was achieved in 9 patients (64%) treated with the Menghini-type needle and in no patient treated with conventional-type needles (P < 0.001). Two patients who had mild post-procedural pancreatitis improved with conservative treatment, and no bleeding occurred in patients treated with the Menghini-type needle.
Conclusion
EUS-guided rolling method with the 21-gauge Menghini-type biopsy needle is useful for the histopathological diagnosis of AIP, due to its abundant acquisition of good-quality tissue from the pancreas.
Keywords
EUS-FNB
ICDC
Sample area
Good-quality tissue
Published Date
2021-01-07
Publication Title
BMC Gastroenterology
Volume
volume21
Issue
issue1
Publisher
BMC
Start Page
21
ISSN
1471-230X
NCID
AA12034934
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
Copyright Holders
© The Author(s) 2021.
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isVersionOf https://doi.org/10.1186/s12876-020-01590-8
License
https://creativecommons.org/licenses/by/4.0/