“Clinical” cytology for endoscopists: A practical guide

Abstract

Clinical cytology was originally used by clinicians to provide rapid diagnosis. However, with advancing medical subspecialization, few clinicians interpret cytology themselves these days, for example, gynecologists, hematologists, urologists, and occasional gastroenterologist (mainly in Asian countries). Cytological assessment enjoyed a renaissance with the development of endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA). Subsequently, pathologists, most of them more experienced in histology, had to take over. Recently, it has been shown that in-room cytology can be easily performed by the endoscopist themselves for initial evaluation of the quality of the EUS-FNA specimen and an initial diagnosis distinguishing benign or malignant cells. Bringing cytology back to the clinician has some advantages but does not substitute the professional cytopathologist. This report has written to lower the threshold for the clinician to find his way back to the microscope, which may improve both their diagnostic yield and assessment of EUS-FNA sample quality.

Comparison of EUS-guided conventional smear and liquid-based cytology in pancreatic lesions: A systematic review and meta-analysis

“…The rationale for using ROSE in EUS-FNA tissue acquisition is that it allows real-time evaluation of sample adequacy and diagnostic yield. Additionally, on-site cytopathologists can determine whether additional sampling is required for further diagnosis or if specimen triage is necessary for additional studies (eg, immunohistochemistry or flow cytometry) 44 45 . Despite its proven advantage 46 47 , ROSE is not readily available in all healthcare centers across the world.…”

Discriminating chronic pancreatitis from pancreatic cancer: Contrast-enhanced EUS and multidetector computed tomography in direct comparison

“…[89] Consequently, it is desirable to find a diagnostic tool that is less invasive and possibly even more accurate. [90] There were no false positive results in EUS-FNA, leaving specificity at 100%. It is worth pointing out that not all lesions were punctured if there was a very high probability for carcinoma or a benign process.…”

Elastography of the Pancreas, Current View

“…Histogram analysis has been applied in diffuse chronic pancreatic diseases, where the colour pattern displayed in the elastogram is related to the fibrous structure caused by the chronic inflammatory disease [18]. Both topics have been extensivle discussed elsewhere [18,19,23,85].…”