Endoscopic ultrasound guided 22 gauge core needle biopsy for the diagnosis of Autoimmune pancreatitis

Pancreatology. 2018 Mar;18(2):168-169. doi: 10.1016/j.pan.2018.01.003. Epub 2018 Jan 10.

Abstract

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.

Keywords: Autoimmune pancreatitis; EUS; FNA; FNB; SharkCore needle.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Antineoplastic Agents, Immunological / therapeutic use
  • Autoimmune Diseases / diagnosis*
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / pathology*
  • Biopsy, Needle / methods
  • Endosonography / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatitis / diagnosis*
  • Pancreatitis / drug therapy
  • Pancreatitis / pathology*
  • Rituximab / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Antineoplastic Agents, Immunological
  • Rituximab