Use of Samples From Endoscopic Ultrasound–Guided 19-Gauge Fine-Needle Aspiration in Diagnosis of Autoimmune Pancreatitis Takuji Iwashita, Ichiro Yasuda,

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Presentation transcript:

Use of Samples From Endoscopic Ultrasound–Guided 19-Gauge Fine-Needle Aspiration in Diagnosis of Autoimmune Pancreatitis Takuji Iwashita, Ichiro Yasuda, Shinpei Doi, Nobuhiro Ando, Masanori Nakashima, Seiji Adachi, Yoshinobu Hirose, Tsuyoshi Mukai, Keisuke Iwata, Eiichi Tomita, Takao Itoi, Hisataka Moriwaki Clinical Gastroenterology and Hepatology Volume 10, Issue 3, Pages 316-322 (March 2012) DOI: 10.1016/j.cgh.2011.09.032 Copyright © 2012 AGA Institute Terms and Conditions

Figure 1 Storiform fibrosis and lymphoplasmacytic infiltration around a small pancreatic duct (H&E staining; original magnification, ×20). Clinical Gastroenterology and Hepatology 2012 10, 316-322DOI: (10.1016/j.cgh.2011.09.032) Copyright © 2012 AGA Institute Terms and Conditions

Figure 2 Obstruction of a vein by the infiltration of inflammatory cells (elastica van Gieson stain; original magnification, ×20). Clinical Gastroenterology and Hepatology 2012 10, 316-322DOI: (10.1016/j.cgh.2011.09.032) Copyright © 2012 AGA Institute Terms and Conditions

Figure 3 Abundant IgG4-positive plasma cells (>10 cells/HPF) with fibrosis, lymphocytes, and negatively stained plasma cells (IgG4 immunostaining; original magnification, ×40). Clinical Gastroenterology and Hepatology 2012 10, 316-322DOI: (10.1016/j.cgh.2011.09.032) Copyright © 2012 AGA Institute Terms and Conditions

Figure 4 A pancreatic lesion on EUS showing a diffuse hypoechoic and enlarged pancreatic parenchyma with scattered hyperechoic foci and a peripancreatic hypoechoic margin (arrowheads) (left, B-mode image; right, color Doppler mode image). EUS-FNA was performed successfully using a 19-gauge needle via the stomach. Clinical Gastroenterology and Hepatology 2012 10, 316-322DOI: (10.1016/j.cgh.2011.09.032) Copyright © 2012 AGA Institute Terms and Conditions

Figure 5 Study profile of histologic assessment. Clinical Gastroenterology and Hepatology 2012 10, 316-322DOI: (10.1016/j.cgh.2011.09.032) Copyright © 2012 AGA Institute Terms and Conditions