title: Brush cytology evaluation of lesions encountered during ERCP.
abstract: Malignant obstruction of the pancreaticobiliary system is a frequent indication for ERCP. Twenty-five patients with abnormalities suggestive of malignancy were encountered during ERCP at our institution and brush cytology was obtained. Positive cytology specimens were collected in 12 of 20 (60%) cases of malignancy causing biliary obstruction. Using a recently developed cytology brush for the biliary tree, detection of malignancy in strictures of the bile duct had a sensitivity of 50% and a specificity of 100%. Both cases of cholangiocarcinoma were diagnosed with cytology, as were 5 of 10 cases of pancreatic cancer. It is concluded that brush cytology is a diagnostically reliable, highly specific technique for malignant lesions encountered at ERCP. In experienced hands, a positive cytologic result may obviate the need for additional invasive diagnostic studies.
authors.affiliation: Department of Pathology, New York Hospital-Cornell Medical Center, New York 10021.
authors.forename: P L
authors.initials: PL
authors.lastname: Scudera
authors.forename: J
authors.initials: J
authors.lastname: Koizumi
authors.forename: I M
authors.initials: IM
authors.lastname: Jacobson
mesh_terms: D002759:Adenoma, Bile Duct / Q000175:diagnosis*; D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis*; D003581:Cytodiagnosis / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D011237:Predictive Value of Tests