cqvip:Background: The diagnosis of autoimmune pancreatitis can be difficult and ofte n requires a larger specimen than can be provided by FNA alone to determine if t he tissue sample obtained with EUS trucut biopsy (TCB) is sufficient to allow ad equate histologic review to establish the diagnosis of autoimmune pancreatitis. Methods: EUS TCB was performed in patients presenting with obstructive jaundice who were suspected of having autoimmune pancreatitis based on their clinical, la boratory and imaging studies. The charts were retrospectively reviewed to determ ine the feasibility of TCB. Results: Between August 2002 and June 2004, 3 patien ts with obstructive jaundice and suspected autoimmune pancreatitis (AIP) underwe nt EUS TCB. In each case, a diagnosis of pancreatic cancer also was considered, and surgical resection was the planned therapy before the patient underwent EUS TCB. Histologic review of the TCB specimens established the diagnosis of AIP in two patients and identified nonspecific changes of chronic pancreatitis in the t hird patient. EUS-guided FNA was performed in two of the 3 patients and failed to establish the diagnosis in either patient. Other than mild transient abdomina l pain (n = 1), no complications were identified. Conclusions: This preliminary study suggests that EUS TCB can safely establish the diagnosis of AIP. Doing so helps guide management and may help to avoid unnecessary surgery. Prosp- ective studies are needed to verify these findings and to more clearly define the role of EUS TCB in these patients.
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