Cytologic features of villous adenoma of the ampullary region

Abstract

Villous adenoma of the ampulla of Vater is a rare but distinct pathologic entity. We studied seven brush cytology specimens from four patients with this unusual lesion all of whom had surgical pathologic confirmation and clinical follow‐up. The distinguishing cytologic appearance includes the presence of slender, elongate columnar cells arranged singly or in small sheets and clusters. Long, thin, basally oriented nuclei occupy about one third of the cell and have fine, granular chromatin with one or more nucleoli. Although brushings of villous adenoma of the ampullary region may reveal a relatively benign but distinctive morphologic pattern, the aggressive nature of these lesions has been well documented, including those in our patients. Diagn Cytopathol 1996;14:145–149. © 1996 Wiley‐Liss, Inc.

Bile Duct Brush Cytology - Challenges, Limitations and Ancillary Studies

“…In the Atypical category, anisonucleosis within a cluster generally amounts to up to threefold variation, even though nuclear enlargement and prominent nucleoli can be seen in marked reactive atypia in the context of stones, stents, PSC etc. Juniper Online Journal of Immuno Virology overcall in atypical reactive cases (Figure 3), while the presence of nuclear stratification with hyperchromasia and elongation in cells of low NC ratio favour BilIN 1 (Figure 4) [8,9]. In addition, BilIN 1 has two distinct populations of cells.…”

“…For better distinction between reactive atypia and malignancy, a targeted FISH analysis of the atypical cells of interest, through use of automated relocation, allows for a more precise evaluation, even in paucicellular specimens [5]. Dudley et al [9] recently compared Next Generation Sequencing (NGS) on biliary cytology specimens to cytology. When NGS and cytology were combined, NGS increased the sensitivity of cancer detection to 85%, whereas UroVysion only increased sensitivity to 76% [10].…”