| Theme | Autoimmune Pancreatitis -- Present Status & Future Perspectives | |
|---|---|---|
| Title | Diagnosis of Autoimmune Pancreatitis with EUS/EUS—FNA | |
| Publish Date | 2018/02 | |
| Author | Tomohisa Iwai | Department of Gastroenterology, Kitasato University School of Medicine |
| Author | Mistuhiro Kida | Department of Gastroenterology, Kitasato University School of Medicine |
| Author | Hiroshi Imaizumi | Department of Gastroenterology, Kitasato University School of Medicine |
| Author | Kosuke Okuwaki | Department of Gastroenterology, Kitasato University School of Medicine |
| Author | Hiroshi Yamauchi | Department of Gastroenterology, Kitasato University School of Medicine |
| Author | Toru Kaneko | Department of Gastroenterology, Kitasato University School of Medicine |
| Author | Wasaburo Koizumi | Department of Gastroenterology, Kitasato University School of Medicine |
| [ Summary ] | Autoimmune pancreatitis (AIP) often causes obstructive jaundice and sometimes forms a tumor like lesion, which is challenging to differentiate from pancreatic cancer in spite of various image examinations. Endoscopic ultrasound (EUS) of AIP generally shows linear or reticular hyperechoic lesions, duct‒penetrating sign, and peripancreatic hyperechoic margins in the low echoic lesion. Histologically, characteristics of type 1 and type 2 are lymphoplasmacystic sclerosing pancreatitis (LPSP) and idiopathic duct‒centric pancreatitis (IDCP), respectively. Tissue acquisition with EUS‒guided fine needle aspiration (EUS‒FNA) performed with a gauge 22 needle has been increasing in recent years in AIP cases. Although the diagnostic ability of EUS‒FNA in AIP is still comparatively low, the ability of ruling out pancreatic cancer is reliable and essential in clinical practice. How to obtain sufficient materials for definite diagnosis of AIP and establish optimal processing method of the specimen is a future task. | |