Needle biopsy compared with surgical biopsy: pitfalls of small biopsy in histologial diagnosis of IgG4-related disease

• Published in: Arthritis research & therapy 2021-02, Vol.23 (1), p.54-54, Article 54
• Main Authors: Liu, Yanying, Yang, Fei, Chi, Xiying, Zhang, Yuxin, Fu, Jiangnan, Bian, Wenjie, Shen, Danhua, Li, Zhanguo
• Format: Article
• Language: English
• Subjects: Analysis; Arthritis; Biopsy; Biopsy, Needle; Classification; Comparative analysis; Diseases; Hospitals; IgG4-related disease; Immunoglobulin G; Lymphatic system; Medical diagnosis; Needle biopsy; Pancreas; Pathology; Pathology consensus; Phlebitis; Prostate; Salivary gland; Serology; Skin; Surgical biopsy
• ISSN: 1478-6362; 1478-6354; 1478-6362
• DOI: 10.1186/s13075-021-02432-y

The growing utilization of needle biopsy has challenged the current pathology consensus of IgG4-related disease (IgG4-RD). The aims of this study were to identify the histological characteristics of needle biopsy and surgical specimens and evaluate the ability of needle biopsy in histological diagnosis of IgG4-RD. Biopsies from patients who were referred to as IgG4-RD by the 2019 ACR/EULAR IgG4-RD classification criteria in Peking University People's Hospital from 2012 to 2019 were re-evaluated. Typical histological features and diagnostic categories were compared between needle biopsy and surgical biopsy. In total, 69 patients met the 2019 ACR/EULAR classification criteria and 72 biopsies of them were re-evaluated. All cases showed lymphoplasmacytic infiltrate, while storiform fibrosis and obliterative phlebitis were only present in 35 (48.6%) and 23 (31.9%) specimens, respectively. Storiform fibrosis was more likely to be seen in retroperitoneum lesion (P = 0.033). Surgical biopsy showed significantly higher IgG4+ plasma cells/high-power field (IgG4/HPF) count (P  10 (P