Bile cytology. Diagnostic role in the management of biliary obstruction.
Thirty satisfactory bile specimens from 21 patients (13 with cancer and 8 with benign conditions) were reviewed to assess the diagnostic role of bile cytology in the management of biliary obstruction. Smears were malignant in 5 instances, suspicious in 1, atypical in 2 (8 in the positive group) and negative in 22. There were no false positives. The diagnostic sensitivity was 38%, specificity 100% and overall accuracy 57%. Of interest were (1) hepatocellular carcinoma, causing obstruction in three patients; (2) metastatic colonic adenocarcinoma, causing obstruction in another instance; (3) positive cytodiagnosis in a patient who developed biliary stricture following laparoscopic cholecystectomy; and (4) detection of acidfast bacilli in bile from a case of tuberculous pseudotumor mimicking a hepatic malignancy. Bile cytology is a simple, inexpensive means of obtaining tissue confirmation of neoplastic and specific inflammatory causes of biliary obstruction. It is a useful adjunct to other techniques in this era of fiberoptic diagnostic procedures. Cell block sections should be prepared whenever possible.
Nilsson
B
B
Department of Pathology, National University Hospital, Repbulic of Singapore.
Wee
A
A
Yap
I
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001646:Bile / Q000166:cytology*; D001649:Bile Duct Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D001661:Biliary Tract Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D002779:Cholestasis / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity