Department of Gastroenterology, Sendai City Medical Center, Sendai, Japan
© 2025 Korean Society of Gastrointestinal Endoscopy
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Conflicts of Interest
The authors have no potential conflicts of interest.
Funding
None.
Author Contributions
Conceptualization: KY, SK; Date curation: KY, SK; Formal analysis: KY, SK, YN, KI; Investigation: KY, SK, YK, TO, HK, TS, KM, FK, HO, YM, KH, HS; Methodology: KY, SK; Project administration: KY, SK; Supervision: SK, KI; Writing–original draft: KY, SK; Writing–review & editing: all authors.
Characteristic | Value |
---|---|
Age (yr) | 71±8.8 |
Sex (male:female) | 38:12 |
Serum IgG4 | |
Median levels (mg/dL) | 281.5 (3.6–1,244) |
≥135 | 39 (78.0) |
≥270 | 24 (48.0) |
Parenchymal imaging | |
Diffuse enlargement | 24 (48.0) |
Focal enlargement | 26 (52.0) |
Other organ involvement | 7 (14.0) |
AIP types on the basis of the ICDC | |
Type 1 AIP | 48 (96.0) |
Definitive | 46 (92.0) |
Probable | 2 (4.0) |
Type 2 AIP | 0 (0) |
AIP-NOS | 2 (4.0) |
Treatment | |
Steroid therapy | 33 (66.0) |
Surveillance | 16 (32.0) |
Surgery | 1 (2.0) |
Characteristic | Value |
---|---|
Needles used for EUS-TA | |
EUS-FNA needles | 18 (36.0) |
EzShot 3 Plus | 8 (16.0) |
Expect | 8 (16.0) |
EchoTip Ultra | 2 (4.0) |
EUS-FNB needles | 32 (64.0) |
Acquire | 18 (36.0) |
EchoTip ProCore | 3 (6.0) |
SonoTip TopGain | 10 (20.0) |
SharkCore | 1 (2.0) |
Needle size | |
19G | 5 (10.0) |
20G | 3 (6.0) |
22G | 40 (80.0) |
25G | 2 (4.0) |
No. of needle passes | 3 (2–4) |
Technical success | 50 (100) |
Adverse events | 0 (0) |
Characteristic | Value |
---|---|
Histlogical diagnosis using EUS-TA specimens | |
LPSP level 1 or 2 | 41 (82.0) |
LPSP level 1 | 33 (66.0) |
LPSP level 2 | 11 (22.0) |
No malignancy | 8 (16.0) |
Suspected adenocarcinoma | 1 (2.0) |
Histlogical findings related to LPSP obtained from EUS-TA | |
Lymphoplasmacytic infiltration | 41 (82.0) |
Abundant (>10 cells/HPF) IgG4-positive plasma cells | 41 (82.0) |
Storiform fibrosis | 33 (66.0) |
Obliterative phlebitis | 12 (24.0) |
Factor | Univariate | Multivariate | |||
---|---|---|---|---|---|
LPSP diagnosed (n=41) | LPSP not diagnosed (n=9) | p-value | OR (95% CI) | p-value | |
Age (yr) | |||||
≥70/<70 | 28/13 | 4/5 | 0.25 | ||
Sex | |||||
Male/female | 30/11 | 8/1 | 0.43 | ||
HbA1c (%) | |||||
≥6.5/<6.5 | 21/20 | 2/7 | 0.15 | ||
Serum IgG4 levels (mg/dL) | |||||
≥135/<135 | 33/8 | 7/2 | 1.0 | ||
≥270/<270 | 21/20 | 3/6 | 0.47 | ||
Parenchymal imaging type | |||||
Diffuse/others | 21/20 | 3/6 | 0.47 | ||
Other organ involvement | |||||
Yes/no | 5/36 | 2/7 | 0.60 | ||
Region punctured | |||||
Head/body or tail | 14/26 | 4/5 | 0.71 | ||
Needle | |||||
FNB needle/FNA needle | 31/10 | 1/8 | <0.01 | 15.1 (1.62–141) | 0.02 |
Needle size | |||||
19G/others | 3/38 | 2/7 | 0.22 | ||
No. of passes | |||||
≥4/<4 | 5/35 | 1/8 | 1.0 | ||
MOSE | |||||
Yes/no | 15/26 | 0/9 | 0.04 | NA | 1.0 |
Characteristic | FNB needles (n=32) | FNA needles (n=18) | p-value |
---|---|---|---|
Needle size | |||
19G | 1 (3.1) | 4 (22.2) | 0.05 |
No. of needle passes | 2 (1–4) | 3 (2–4) | <0.01 |
Adequacy score of specimen | |||
0 | 0 (0) | 0 (0) | |
1 | 0 (0) | 0 (0) | |
2 | 0 (0) | 3 (16.7) | |
3 | 1 (3.1) | 5 (27.8) | |
4 | 10 (31.3) | 7 (38.9) | |
5 | 21 (65.6) | 3 (16.7) | |
Adequacy tissue acquisition rate (adequacy score of specimen ≥4) | 31 (96.9) | 10 (55.6) | <0.01 |
Histological diagnoses for LPSP | |||
LPSP level 1 or 2 | 31 (96.9) | 10 (55.6) | <0.01 |
LPSP level 1 | 24 (75.0) | 9 (50.0) | 0.12 |
LPSP level 2 | 10 (31.3) | 1 (5.6) | 0.07 |
Histlogical findings related to LPSP obtained from EUS-TA | |||
Lymphoplasmacytic infiltration | 31 (96.9) | 10 (55.6) | <0.01 |
Abundant (>10 cells/HPF) IgG4-positive plasma cells | 30 (93.8) | 11 (61.1) | <0.01 |
Storiform fibrosis | 24 (75.0) | 9 (50.0) | 0.12 |
Obliterative phlebitis | 10 (31.3) | 2 (11.1) | 0.17 |
Values are presented as mean±standard deviation, median (range), or number (%) unless otherwise indicated. AIP, autoimmune pancreatitis; EUS-TA, endoscopic ultrasound-guided tissue acquisition; Ig, immunoglobulin; ICDC, Internal Consensus Diagnostic Criteria; NOS, not otherwise specified.
Values are presented as number (%) or median (range). EUS, endoscopic ultrasound; EUS-TA, EUS-guided tissue acquisition; EUS-FNA, EUS-guided fine needle aspiration; EUS-FNB, EUS-guided fine needle biopsy; G, gauge.
Values are presented as number (%). EUS-TA, endoscopic ultrasound-guided tissue acquisition; AIP, autoimmune pancreatitis; LPSP, lymphoplasmacytic sclerosing pancreatitis; HPF, high-power field.
LPSP, lymphoplasmacytic sclerosing pancreatitis; OR, odds ratios; CI, confidence intervals; Ig, immunoglobulin; FNB, fine needle biopsy; FNA, fine needle aspiration; G, gauge; MOSE, macroscopic on-site evaluation; NA, not applicable.
Values are presented as number (%) or median (range). FNB, fine needle biopsy; FNA, fine needle aspiration; G, gauge; LPSP, lymphoplasmacytic sclerosing pancreatitis; HPF, high-power field; Ig, immunoglobulin.