Postbrushing and fine‐needle aspiration biopsy follow‐up and treatment options for patients with pancreatobiliary lesions: The papanicolaou society of cytopathology guidelines

Abstract

The papanicolaou society of cytopathology (PSC) has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) biopsy, techniques of EUS-FNA, terminology and nomenclature for pancreatobiliary cytology, ancillary testing, and postprocedure management. All documents are based on the expertise of the authors, a review of the literature, discussions of the draft document at several national and international meetings over an 18 month period and synthesis of online comments of the draft document on the PSC web site [www.papsociety.org]. This document selectively presents the results of these discussions and focuses on the follow-up and treatment options for patients after procedures performed for obtaining cytology samples for the evaluation of biliary strictures and solid and cystic masses in the pancreas. These recommendations follow the six-tiered terminology and nomenclature scheme proposed by Committee III.

The new guidelines of Papanicolaou Society of Cytopathology for respiratory specimens: Assessment of risk of malignancy and diagnostic yield in different cytological modalities

“…For BAL specimens, the low ratio of sensitivity (23%-34%) and high ratio of specificity (97%-100%) were consistent with previous reports. 12,13 In line with prior categorization schemes, such as the Bethesda system for reporting thyroid cytopathology 13 and the Standardized terminology and nomenclature for pancreatobiliary cytology of the PSC, [14][15][16] the recent PSC classification of lung cytology also was designed for better communication between clinicians and pathologists. The system was prepared with the specific ROM for each category to directly influence clinical management algorithm for a rational patient management and also to deal with some issues in the daily practice.…”

The impact of the new proposed Papanicolaou Society of Cytopathology terminology for pancreaticobiliary cytology in endoscopic US‐FNA: A single‐Institutional experience

“…These new guidelines also include a proposed management for each category, a detailed description of the main morphologic characteristics of each listed diagnosis, and recommendations on the use of ancillary techniques. The novel terminology proposal aims to standardize diagnostic categories among multiple centers and provide benefits for tailored patient management together with recommendations for tumor sampling, treatment options, and the use of ancillary techniques . Therefore, in the current study, we applied the new proposed terminology for pancreaticobiliary cytology to a retrospective set of EUS‐FNA pancreatic cytologic specimens and verified its sensitivity and specificity, correlating the results with the final surgical diagnoses from resected specimens.…”

Guidelines for pancreaticobiliary cytology from the Papanicolaou Society of Cytopathology: A review

“…The PSC has a long history of producing guidelines for the interpretation and reporting of cytologic specimens derived from various body sites . Similar to the National Cancer Institute recommendations for aspiration cytology of the thyroid, the PSC guidelines for pancreaticobiliary cytology addresses indications, techniques, terminology and nomenclature, ancillary studies, and postprocedure management …”

“…Optimally, patient treatment is based on a specific diagnosis, which is not always possible with only cytology due to limitations of sampling and the availability of tissue for ancillary tests, as well as the less than 100% specificity of these tests . General categorization of a lesion, however, may be sufficient to guide treatment.…”