title: Role of cytology in the diagnosis of Barrett's esophagus and associated neoplasia.
abstract: We studied 327 consecutive paired esophageal biopsies and brushing specimens obtained during the same endoscopic session to evaluate the role of cytology for the diagnosis of Barrett's esophagus (BE) and/or surveillance for associated dysplasia. A diagnosis of BE was based on the cytologic presence of goblet cells. Cases were reviewed and categorized into: 1) benign esophageal lesions (125 cases), with 48 cases of Candida (32 cases diagnosed by both techniques and 16 diagnosed only by cytology), 3 cases of herpes simplex with only 1 case diagnosed by cytology, and 74 cases of inflammation and/or repair; 2) benign BE (141 cases), with 74 cases (52%) diagnosed by both techniques, 11 cases by cytology only (8%), and 56 cases (40%) by histology only; 3) low-grade dysplasia (LGD, 30 cases), with 5 cases (17%) diagnosed with both specimens, one case (3%) by cytology only, and 24 cases (80%) by histology only; 4) high-grade dysplasia (HGD, 10 cases), with 8 cases (80%) diagnosed with both specimens, 1 case (10%) by cytology, and 1 case (10%) by histology; and 5) carcinomas (23 cases), with 20 cases (87%) diagnosed with both specimens, 2 cases (9%) by cytology only, and 1 case (4%) by histology only. Our results support the high degree of diagnostic accuracy of cytology for the diagnosis of Barrett's-associated HGD and/or carcinoma, and moderate sensitivity for BE.
authors.affiliation: Department of Pathology, Allegheny General Hospital/Drexel University College of Medicine, Pittsburgh, Pennsylvania 15212, USA. redasaad2@hotmail.com
authors.forename: Reda S
authors.initials: RS
authors.lastname: Saad
authors.forename: Laura K
authors.initials: LK
authors.lastname: Mahood
authors.forename: Karen M
authors.initials: KM
authors.lastname: Clary
authors.forename: Yulin
authors.initials: Y
authors.lastname: Liu
authors.forename: Jan F
authors.initials: JF
authors.lastname: Silverman
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Raab
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D001471:Barrett Esophagus / Q000473:pathology*; D003581:Cytodiagnosis / Q000295:instrumentation / Q000379:methods*; D003584:Cytological Techniques; D004938:Esophageal Neoplasms / Q000473:pathology*; D004945:Esophagoscopy; D006801:Humans; D015203:Reproducibility of Results; D012189:Retrospective Studies