Significance of atypia in pancreatic and bile duct brushings: follow-up analysis of the categories atypical and suspicious for malignancy.

Abstract:

:Brushing cytology is frequently utilized for the investigation of pancreatic and biliary strictures but is associated with low diagnostic sensitivity. The Papanicolaou Society of Cytopathology has presented a system for diagnostic classification which includes the categories benign, atypical, suspicious for malignancy and malignant. We studied a series of 216 pancreatic and biliary brushings with either histologic follow-up or a minimum of 6 months clinical follow-up to determine outcomes for the diagnostic categories ("benign," "atypical, favor reactive," "atypical, not otherwise specified," "atypical, suspicious" and "malignant"). Eighty-six of the 216 (39.8%) were designated "atypical" with 10 of these designated as "atypical favor reactive." Forty-five were called "atypical not otherwise specified" and 31 were interpreted as "atypical suspicious for malignancy." On follow-up, 2 of 10 (20%) "atypical favor reactive" were eventually associated with a malignant diagnosis and 23 of 31 (74.2%) "atypical, suspicious for malignancy" demonstrated a malignant outcome. The remaining 45 brushings in the "atypical" category were "atypical not otherwise specified," and 62% of these were associated with malignancy on follow-up. Stratification of the "atypical" category into "atypical favor reactive," "atypical, not otherwise specified" and "atypical, suspicious for malignancy" improves diagnostic accuracy. The "atypical suspicious for malignancy" category has a follow-up similar to the "malignant" category while the "atypical favor reactive" category is associated with a clinical outcome similar to that of the "benign" category.

journal_name

Diagn Cytopathol

journal_title

Diagnostic cytopathology

authors

Chadwick BE,Layfield LJ,Witt BL,Schmidt RL,Cox RN,Adler DG

doi

10.1002/dc.23035

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

285-91

issue

4

eissn

8755-1039

issn

1097-0339

journal_volume

42

pub_type

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