Utility of endoscopic ultrasound-guided fine-needle biopsy in the diagnosis of type 1 autoimmune pancreatitis.
Endosc Int Open
; 8(12): E1855-E1861, 2020 Dec.
Article
in En
| MEDLINE
| ID: mdl-33269321
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 (±âSD) 62.2 (±â11.4), 17 (70.8â%) male. No RB samples were diagnostic compared to 14 (78â%) FT; P â=â0.001; of which 13 (72â%) were level 1.âIn eight (44â%) of FT cases a diagnosis was not possible without histology. Initial biopsy was diagnostic in five (62.5â%) of these cases. Including repeat biopsy, seven (87â%) had a diagnosis made by FT needle. Obliterative phlebitis (44â%) was the least frequently identified pathological feature and immunoglobulin (IgG)4â+âplasma cells >â10 per high power field (78â%) 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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Language:
En
Journal:
Endosc Int Open
Year:
2020
Type:
Article
Affiliation country:
United kingdom