菅野 敦¹, 玉田 喜一¹, 福嶋 敬宜², 瓦井 Lefor Alan³, 山本 博徳¹

Atsushi KANNO¹, Kiichi TAMADA¹, Noriyoshi FUKUSHIMA², Alan Kawarai LEFOR³, Hironori YAMAMOTO¹

¹自治医科大学消化器内科, ²自治医科大学病理診断部, ³自治医科大学外科

¹Division of Gastroenterology, Department of Medicine, Jichi Medical University, ²Department of Pathology, Jichi Medical University, ³Department of Surgery, Jichi Medical University

キーワード : autoimmune pancreatitis, biopsy, fine needle, endoscopic ultrasound-guided fine-needle aspiration

自己免疫性膵炎（autoimmune pancreatitis：AIP）は，日本から最初に報告された疾患である．典型的なAIPの形態的な特徴は,　びまん性の膵腫大と膵管の不整狭細像である．超音波内視鏡下穿刺吸引法（endoscopic ultrasound-guided fine-needle aspiration：EUS-FNA）や超音波内視鏡下穿刺生検法（EUS-guided fine-needle biopsy：EUS-FNB）による組織診断の有用性が報告されているが，組織採取法や穿刺針の性能向上による診断能の進歩が期待されている．AIPの病理組織学的診断のガイダンスも作成され，AIPの組織診断に寄与している．今後，EUS-FNA/FNBによる病理組織診断がAIP診断の中心的な役割を担うと考えられる．

Autoimmune pancreatitis (AIP) is a disease concept that originated in Japan. It is characterized by diffuse pancreatic enlargement and irregular narrowing of the main pancreatic duct. Although the usefulness of the histological diagnosis of AIP using endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) and EUS-guided fine-needle biopsy (FNB) has been reported, enhanced diagnostic performance is expected with improvements in tissue collection methods and fineneedle techniques. Guidance for establishing the tissue diagnosis of AIP has been developed and is useful for histological evaluation. Histopathological diagnosis by EUS-FNA/FNB is expected to play a central role in AIP diagnosis in the future.