Brush cytology of the extrahepatic biliary tract: comparison of cytologic features of adenocarcinoma and benign biliary strictures

M B Cohen; R J Wittchow; F C Johlin; K Bottles; S S Raab

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Brush cytology of the extrahepatic biliary tract: comparison of cytologic features of adenocarcinoma and benign biliary strictures

Journal article

Peer reviewed

Brush cytology of the extrahepatic biliary tract: comparison of cytologic features of adenocarcinoma and benign biliary strictures

M B Cohen, R J Wittchow, F C Johlin, K Bottles and S S Raab

Modern pathology, Vol.8(5), pp.498-502

06/1995

PMID: 7675767

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Abstract

Malignant strictures of the extrahepatic biliary tract are difficult to discern from benign strictures solely by clinical and/or radiographic findings. Endoscopic retrograde wire-guided brushings of strictures have proven to be useful in evaluating such lesions. Because the reported sensitivity of diagnosing adenocarcinoma of the extrahepatic biliary tract by this technique has varied considerably (44 to 100%), we undertook a retrospective study to determine if the diagnostic accuracy could be increased by identifying key cytologic features by reviewing a series of 90 biliary tract brushings from 80 patients. The cytologic diagnosis was confirmed either by additional pathologic material and/or clinical follow-up. Utilizing a multiple logistic regression analysis, three key cytologic features were identified that were useful in separating benign from malignant strictures; these features included: nuclear molding, chromatin clumping, and increased nuclear-cytoplasmic ratio. The presence of two of these three features resulted in a sensitivity of 83%; the corresponding specificity was 98%. The use of these key features should aid the cytologist in better recognizing malignant cells in biliary tract brushings.

Regression Analysis

Diagnosis, Differential

Adenocarcinoma - pathology

Follow-Up Studies

Humans

Sensitivity and Specificity

Endoscopy, Gastrointestinal

Bile Ducts, Extrahepatic - pathology

Retrospective Studies

Bile Duct Neoplasms - pathology

Cholestasis, Extrahepatic - pathology

Details

Title: Subtitle: Brush cytology of the extrahepatic biliary tract: comparison of cytologic features of adenocarcinoma and benign biliary strictures
Creators: M B Cohen - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, USA
R J Wittchow
F C Johlin
K Bottles
S S Raab
Resource Type: Journal article
Publication Details: Modern pathology, Vol.8(5), pp.498-502
PMID: 7675767
ISSN: 0893-3952
eISSN: 1530-0285
Language: English
Date published: 06/1995
Academic Unit: Gastroenterology and Hepatology; Pathology; Internal Medicine
Record Identifier: 9984094593902771

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