title: Intraoperative bile cytology of the dysplasia-carcinoma in situ sequence of gallbladder carcinoma.
abstract: BACKGROUND
  The preoperative diagnosis of noninvasive and early carcinoma of the gallbladder is considered to be both difficult and exceptional. In the current study, the authors conducted a cytologic analysis of bile in the intraoperative diagnosis of clinically unsuspected gallbladder carcinoma.
  
  
  METHODS
  Bile samples collected from 40 patients at the time of elective cholecystectomy were centrifuged. Smears prepared from the sediments were stained with May-Grünwald-Giemsa and Papanicolaou stains. Lesions were categorized as hyperplasia with or without metaplasia, dysplasia, carcinoma in situ, and invasive carcinoma. Cytologic diagnoses were compared with histopathology.
  
  
  RESULTS
  Two cases of carcinoma in situ and one case of invasive carcinoma diagnosed on bile cytology were confirmed by histopathology. No false-positive diagnoses were made based on cytologic examination of aspirated bile. Cytohistologic concordance in cases of hyperplasia, dysplasia, and chronic cholecystitis varied from 56-60%.
  
  
  CONCLUSIONS
  Intraoperative bile cytology was found to be a reliable method for the detection of in situ and early invasive carcinoma of the gallbladder.
authors.affiliation: Department of Pathology, University College of Medical Sciences and Guru Teg Bhadur Hospital, Shahdhara, Delhi, India.
authors.forename: Vinod Kumar
authors.initials: VK
authors.lastname: Arora
authors.forename: Sunil
authors.initials: S
authors.lastname: Kumar
authors.forename: Navjeevan
authors.initials: N
authors.lastname: Singh
authors.forename: Arati
authors.initials: A
authors.lastname: Bhatia
mesh_terms: D000328:Adult; D001646:Bile / Q000166:cytology*; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D002763:Cholecystectomy; D005189:False Positive Reactions; D005260:Female; D005704:Gallbladder / Q000473:pathology; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity