Biliary tract cytology in specimens obtained by direct cholangiographic procedures: A study of 74 cases

摘要: A retrospective review of bile (BL) and biliary tract brushings (Br) obtained by endoscopic retrograde cholangiopancreatography (ERCP) percutaneous transhepatic cholangiography (PTC) was undertaken to determine the sensitivity specificity cytology in diagnosis pancreaticobiliary malignancies. total 104 cytologic specimens (PTC-BL 15, PTC-Br 13, ERCP-BL 8, ERCP-Br 68) received between 1990 mid-1994 from 77 patients who had undergone ERCP and/or PTC primarily for stricture were reviewed. Specimens unsatisfactory/inadequate 11 (10.6%), benign 41 (39.4%), suspicious 25 (24%), positive malignant cells 27 (26%). Follow-up available 74/77 patients; 46 (59.7%) tissue confirmation while 28 (32.5%) adequate clinical follow-up based on chart review. Of those with histologic confirmation, there 32 14 cases. The overall PTC- ERCP-obtained 88.9 95.7% respectively. There only one false case (ERCP-Br). Overall predictive value 96%, negative 88%, accuracy 96%. a significantly lower rate (42.8%) higher unsatisfactory (21%) compared material (100 1.9%). Bile or appeared less sensitive detecting malignancies brushing using either technique (BL 50% vs. Br 100%). All three cases PTC-BL specimens. 17 cases, eight confirmed histologically as malignant, four clinically consistent malignancy, five showed marked inflammatory atypia biopsy. Positive “suspicious cytology” 69 80.5%, Inadequate specimen, poor cellular preservation, obscured all interfere proper evaluation. Experience is necessary appreciate subtle changes well differentiated carcinomas. Communication cytopathologist clinician critical accurate interpretation management patients. Diagn Cytopathol 1996;14:334–348. © 1996 Wiley-Liss, Inc.