Yield of EUS-guided FNA on the diagnosis of pancreatic/peripancreatic tuberculosis
Yield of EUS-guided FNA on the diagnosis of pancreatic/peripancreatic tuberculosis
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DOI：
10.1016/j.gie.2008.10.007
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发表时间：
2009-03-01
影响因子：
7.7
通讯作者：
Kim, Myung-Hwan
中科院分区：
文献类型：
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作者：
Song, Tae Jun;Lee, Sang Soo;Kim, Myung-Hwan
背景：胰腺/胰周结核（TB）是一种非常罕见的临床实体，即使在结核病高发国家也是如此。EUS引导下细针穿刺活检（EUS-FNA）诊断胰腺/胰周结核仍然是一个挑战，因为内镜医师在这种情况下的专业知识有限。目的：本研究评估了EUS-FNA在胰腺/胰周结核患者中的产量和有用性。设计：进行回顾性分析。设置：韩国首尔的一家三级教学医院。患者：对2003年9月至2007年4月期间接受EUS-FNA的21例胰腺/胰周TB患者的基线人口统计学和临床特征进行了评估。平均病变直径为31.3 ± 14.6 mm。组织病理学检查为肉芽肿性炎症占61.9%，15个病人中有10个结核病聚合酶链反应（PCR）阳性率为66.7%，其中4例Ziehl-Neelsen染色阳性结核分枝杆菌培养阳性3例（37.5%）。EUS-FNA正确诊断胰腺/胰周结核16例（76.2%）。因此，避免了不必要的手术，为这些patients.Limitation：一项回顾性研究。结论：EUS-FNA是一种安全和有前途的方法，用于胰腺/胰周结核的诊断。使用这种方法可以帮助我们避免使用手术，并提供及时准确的诊断。（Gastrointest Endosc 2009;69：484-91.）
Background: Pancreatic/peripancreatic tuberculosis (TB) is a very rare clinical entity, even in countries with high incidences of TB. The diagnosis of pancreatic/peripancreatic TB with EUS-guided FNA (EUS-FNA) remains a diagnostic challenge because of limitations of the endoscopists' expertise on this condition.Objective: This study evaluated the yield and usefulness of EUS-FNA in patients with pancreatic/peripancreatic TB.Design: A retrospective analysis was performed.Setting: A tertiary teaching hospital in Seoul, Korea.Patients: Baseline demographic and clinical features were evaluated in 21 consecutive patients with pancreatic/peripancreatic TB who underwent EUS-FNA between September 2003 and April 2007.Results: The mean lesion diameter was 31.3 +/- 14.6 mm. Thirteen patients (61.9%) showed granulomatous inflammation on histopathologic examination, and 10 of 15 patients (66.7%) were positive on a TB polymerase chain reaction assay Ziehl-Neelsen staining was positive in 4 of 15 patients (26.7%), and 3 of 8 patients (37.5%) had cultures positive for Mycobacterium tuberculosis. EUS-FNA correctly diagnosed pancreatic/peripancreatic TB in 16 patients (76.2%). Therefore, unnecessary surgery was avoided for these patients.Limitation: A retrospective study.Conclusions: EUS-FNA is a safe and promising method for the diagnosis of pancreatic/peripancreatic TB. Use of this method may help us to avoid the use of surgery and provide timely and accurate diagnosis. (Gastrointest Endosc 2009;69:484-91.)