内镜超声引导下 22 号穿刺针活检用于自身免疫性胰腺炎的诊断。
Endoscopic ultrasound guided 22 gauge core needle biopsy for the diagnosis of Autoimmune pancreatitis.
机构信息
Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Foundation, Cleveland, OH, USA.
Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, OH, USA.
出版信息
Pancreatology. 2018 Mar;18(2):168-169. doi: 10.1016/j.pan.2018.01.003. Epub 2018 Jan 10.
BACKGROUND
It is difficult to obtain adequate tissue sample for diagnosing autoimmune pancreatitis (AIP) with the help of traditional EUS-guided FNA. As per ICDC guidelines, EUS-guided FNA is not recommended for diagnosing AIP(1). We herein present a report of 2 cases of using a new flexible 22 gauge (G) core biopsy needle (SharkCore, Medtronic, Sunnydale, Calif) for diagnosing AIP.
METHODS
This is a report of 2 cases reviewed retrospectively which had used 22G core biopsy needle for obtaining histo-pathological samples for diagnosing AIP. The cases were reviewed with both endoscopist and a pathologist to determine if the diagnostic criteria were met.
RESULTS
Both the cases had adequate tissue sample obtained to make a clear diagnosis of AIP. Pathology showed changes of chronic pancreatitis with atrophy and storiform pattern of fibrosis with a dense lymphoplasmacytic infiltrate in both cases along with identification of IgG4 cells.
CONCLUSION
EUS-guided fine needle biopsy (FNB) using the SharkCore needle can be used reliably for diagnosing AIP. More studies need to be performed to validate this further.
背景
在传统的 EUS 引导下 FNA 的帮助下，很难获得足够的组织样本来诊断自身免疫性胰腺炎（AIP）。根据 ICDC 指南，不建议使用 EUS 引导下 FNA 来诊断 AIP(1)。我们在此报告 2 例使用新型灵活的 22 号（G）活检针（SharkCore，Medtronic，Sunnydale，加利福尼亚州）诊断 AIP 的病例。
方法
这是回顾性报告的 2 例病例，使用 22G 活检针获取组织病理学样本以诊断 AIP。对病例进行内镜医师和病理学家的联合评估，以确定是否符合诊断标准。
结果
这 2 例病例均获得了足够的组织样本，明确诊断为 AIP。病理学显示慢性胰腺炎的改变，伴有萎缩和纤维化的索状模式，2 例均伴有密集的淋巴浆细胞浸润，同时还鉴定出 IgG4 细胞。
结论
EUS 引导下使用 SharkCore 活检针进行细针活检（FNB）可可靠地用于诊断 AIP。需要进一步开展更多研究来验证这一点。
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