Document Detail

The Role of Cytology in the Preoperative Assessment and Management of Patients with Pancreaticobiliary Tract Neoplasms.
MedLine Citation:
PMID:  23297029     Owner:  NLM     Status:  Publisher    
OBJECTIVE: Endoscopic ultrasound-guided fine-needle aspiration and bile duct brushings are utilized in the cytologic evaluation of solid and cystic pancreaticobiliary tract lesions. We sought to determine the diagnostic accuracy of cytology. METHODS: Five hundred seventy-nine pancreatic resections with 727 corresponding cytology specimens were identified from 1997 to 2012. Histologic diagnoses included benign, carcinoma, pancreatic endocrine neoplasm (PEN), nonepithelial neoplasms, cystic neoplasms, and ampullary adenomas. Standard interpretative categories-nondiagnostic, negative, atypical, suspicious, and positive-were utilized for preoperative cytology specimens. RESULTS: For solid masses, the sensitivity and specificity of positive fine-needle aspiration (FNA) cytology for detecting carcinoma were 74 and 100 %, respectively. FNAs performed better than brushings (sensitivity, 40 %; specificity, 98 %) in detecting carcinomas. Similar findings were seen for PENs and nonepithelial neoplasms. For cystic lesions, the sensitivity of FNA for predicting malignancy was lower (24 %) with a specificity of 97 %. Sequentially combining suspicious and atypical categories with the positive category resulted in increases in sensitivity and decreases in specificity for all cases except for cystic lesions. CONCLUSIONS: Cytology adds to the assessment of solid masses, but its utility in cystic lesions is less clear. Consideration of a suspicious cytologic interpretation as a positive diagnosis for triaging patients to surgery is supported by our study.
Judy C Pang; Rebecca M Minter; Richard S Kwon; Diane M Simeone; Michael H Roh
Related Documents :
11722529 - Mohs micrographic surgery-induced pemphigus.
11428779 - Development of a bullous pemphigoid after split-skin grafting.
25087589 - Clinically atypical spitzoid lesions: semi-quantitative histologic index correlation wi...
24398479 - Retrospective review of eyelash number in patients who have undergone full-thickness ey...
24086799 - Where is the lesion? glomus tumours of the hand.
2430879 - Reactive perforating collagenosis: light, ultrastructural and immunohistological studies.
2928919 - Embolization of solitary spinal metastases from renal cell carcinoma: alternative thera...
24638459 - Diffuse reticular nodular cavity shadows: a rare manifestation of bronchioalveolar carc...
16698629 - Power doppler in the assessment of pelvic masses in a low risk group.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-8
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  -     ISSN:  1873-4626     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Pathology, University of Michigan Health System, 1500 E. Medical Center Dr., 2G340, Ann Arbor, MI, 48109-5054, USA,
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  The prognostic influence of resection margin clearance following pancreaticoduodenectomy for pancrea...
Next Document:  The Concept of Laparoscopy-Assisted Pancreatobiliary EUS (LAP-EUS).