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Diagnosis of autoimmune pancreatitis by EUS-guided FNA using a 22-gauge needle: a prospective multicenter study  Atsushi Kanno, MD, PhD, Atsushi Masamune,

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Presentation on theme: "Diagnosis of autoimmune pancreatitis by EUS-guided FNA using a 22-gauge needle: a prospective multicenter study  Atsushi Kanno, MD, PhD, Atsushi Masamune,"— Presentation transcript:

1 Diagnosis of autoimmune pancreatitis by EUS-guided FNA using a 22-gauge needle: a prospective multicenter study  Atsushi Kanno, MD, PhD, Atsushi Masamune, MD, PhD, Fumiyoshi Fujishima, MD, PhD, Takuji Iwashita, MD, PhD, Yuzo Kodama, MD, PhD, Akio Katanuma, MD, Hirotaka Ohara, MD, PhD, Masayuki Kitano, MD, PhD, Hiroyuki Inoue, MD, PhD, Takao Itoi, MD, PhD, Nobumasa Mizuno, MD, PhD, Hiroyuki Miyakawa, MD, PhD, Rintaro Mikata, MD, PhD, Atsushi Irisawa, MD, PhD, Satoko Sato, MD, PhD, Kenji Notohara, MD, PhD, Tooru Shimosegawa, MD, PhD  Gastrointestinal Endoscopy  Volume 84, Issue 5, Pages e1 (November 2016) DOI: /j.gie Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions

2 Figure 1 Macroscopic findings of the specimens obtained by EUS-FNA with a 22G needle demonstrated adequate specimens for histopathologic diagnosis (H&E, orig. mag. ×10). Gastrointestinal Endoscopy  , e1DOI: ( /j.gie ) Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions

3 Figure 2 The findings in high-power fields (H&E, orig. mag. ×400) reveal abundant lymphoplasmacytic infiltration. Gastrointestinal Endoscopy  , e1DOI: ( /j.gie ) Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions

4 Figure 3 IgG4 immunostaining in the specimens obtained by EUS-FNA shows markedly increased numbers of IgG4-positive plasma cells (orig. mag. ×400). Gastrointestinal Endoscopy  , e1DOI: ( /j.gie ) Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions

5 Figure 4 Immunohistochemical staining of CD38. Abundant CD38-positive plasma cells were found in the high-power field (orig. mag. ×400). Gastrointestinal Endoscopy  , e1DOI: ( /j.gie ) Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions

6 Figure 5 A specimen showing storiform fibrosis in high-power fields (H&E, orig. mag. ×400). Gastrointestinal Endoscopy  , e1DOI: ( /j.gie ) Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions

7 Figure 6 Obstructive phlebitis revealed by (A) H&E and (B) Elastica-Masson staining (orig. mag. ×200) shows that the infiltration of inflammatory cells obstructed the vein. Gastrointestinal Endoscopy  , e1DOI: ( /j.gie ) Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions

8 Figure 7 Flowchart illustrating the summary of this study focusing on the diagnosis according to the ICDC. AIP, autoimmune pancreatitis; OOI, other organ involvement; ICDC, International consensus diagnostic criteria. Gastrointestinal Endoscopy  , e1DOI: ( /j.gie ) Copyright © 2016 American Society for Gastrointestinal Endoscopy Terms and Conditions


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