title: Telecytology of fine-needle aspiration biopsies of the pancreas: a study of well-differentiated adenocarcinoma and chronic pancreatitis with atypical epithelial repair changes.
abstract: Four experienced cytopathologists provided consultations using telecytology and routine microscopy. Twenty-seven fine-needle aspiration biopsies (FNABs) from patients with chronic pancreatitis with atypical epithelial repair changes (n = 9) and pancreatic low-grade adenocarcinomas (LG-AC) (n = 18) were studied. False-positive and false-negative diagnostic rates were 19.4% and 12.5% by microscopy and 11.1% and 2.8% by telecytology. Comparisons of agreements between the correct diagnoses and consultations rendered by the two methods and among the diagnoses rendered on the same cases by the two modalities yielded kappa coefficients ranging from 0.444-1.000. Telecytology yielded slightly better kappa coefficients than microscopy. This method, which to our knowledge has not been previously applied to pancreatic FNAB, provides a potentially useful consultative tool for the interpretation of these difficult specimens. The diagnosis of FNAB from patients with chronic pancreatitis and LG-AC is difficult even for experienced consultants, as underscored by the considerable intraobserver and interobserver variability encountered in this study.
authors.affiliation: Department of Pathology, Cedars-Sinai Medical Center Los Angeles, California 90048, USA.
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Marchevsky
authors.forename: Viera
authors.initials: V
authors.lastname: Nelson
authors.forename: Sue Ellen
authors.initials: SE
authors.lastname: Martin
authors.forename: T S
authors.initials: TS
authors.lastname: Greaves
authors.forename: A S
authors.initials: AS
authors.lastname: Raza
authors.forename: J
authors.initials: J
authors.lastname: Zeineh
authors.forename: Camilla J
authors.initials: CJ
authors.lastname: Cobb
mesh_terms: D001707:Biopsy, Needle; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology*; D003951:Diagnostic Errors; D004847:Epithelial Cells / Q000473:pathology / Q000502:physiology; D015588:Observer Variation; D010179:Pancreas / Q000473:pathology / Q000502:physiology; D010190:Pancreatic Neoplasms / Q000473:pathology*; D010195:Pancreatitis / Q000473:pathology*; D012038:Regeneration; D015203:Reproducibility of Results; D019113:Telepathology