EUS-guided fine needle biopsy sampling in autoimmune pancreatitis: Is needle tip design more important than needle size?

Endosonographers encounter a lot of puzzling situations and conditions. One such condition is autoimmune pancreatitis (AIP). The typical radiological presentation in autoimmune pancreatitis is a “sausage-shaped” pancreas with parenchymal enlargement, peripancreatic halo, and a general narrowing of the pancreatic duct [1]. However, AIP can also present with a focal pancreatic mass that may be impossible to distinguish from pancreatic ductal adenocarcinoma (PDAC) solely based on imaging [2] [3]. Clinical management of AIP and PDAC are completely different and misdiagnosis of AIP as PDAC may have deleterious consequences for the patient, including unnecessary and extensive pancreatic surgery, chemotherapy, and withholding of a potentially curative treatment (corticosteroids and/or other immunosupressants) [2] [4] [5]. Moreover, the prognosis for AIP is far better than for PDAC, with long-term survival to be expected in the majority of patients.

Publication History

Article published online:
27 November 2020

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