Reporting the Presence of Signi.cant Epithelial Atypia in Pancreaticobiliary Brush Cytology Specimens Lacking Evidence of Obvious Carcinoma

Bile duct brushings cytology – improving sensitivity of diagnosis using the ThinPrep® technique: a review of 113 cases

“…Our review of the literature to date shows that studies with higher sensitivities in general represent observations in smaller study populations 3,7,8 . The larger studies in general show sensitivities in the range of 42–59%, comparable with our results 2,4,8–13 .…”

“…Endoscopic brush cytology of the biliary and pancreatic duct systems was first described as a potentially useful diagnostic technique 30 years ago 17 . This technique has, however, been compromised somewhat by relatively low sensitivity 1,2,4,8,10 . These sites still remain difficult to obtain a tissue biopsy from in many cases yet tissue diagnosis is essential to direct patient management.…”

“…The suspicious group, if diagnostic criteria were adhered to, should have a high PPV for malignancy. In most previous studies, suspicious and malignant categories were grouped together for calculating PPV, as we did in this study 7,8,11,12 …”

“…Methods of specimen collection include the making of conventional smears and, more recently, use of the ThinPrep ® technique 1,7,9–11 . Sensitivity of CBD brushings has been shown to be relatively low in several studies with a broad range (42–88%) while specificity is much higher (97–100%) 2,4,7–15 . As the potential value of CBD brushings is increasingly recognized, it is desirable to consider all factors which might improve sensitivity.…”

Role of biliary tract cytology in the evaluation of extrahepatic cholestatic jaundice

“…A diagnosis of atypia or lack of obvious features of carcinoma on smears should prompt the clinician to perform repeat brushings or additional studies to establish a conclusive diagnosis of malignancy,[21] as observed in the present study. Volmar et al .…”