title: Pancreatic duct lavage cytology with the cell block method for discriminating benign and malignant branch-duct type intraductal papillary mucinous neoplasms.
abstract: BACKGROUND
  Differentiation between benign and malignant branch-duct type intraductal papillary mucinous neoplasms (IPMNs) remains challenging.
  
  
  OBJECTIVE
  To examine the usefulness of pancreatic duct lavage cytology with cell block method for discriminating benign and malignant branch-duct type IPMNs.
  
  
  METHODS
  Between December 2007 and April 2011, patients with branch-duct type IPMNs having mural nodules on EUS were examined by pancreatic duct lavage cytology by using the cell block method. Cell block sections underwent hematoxylin and eosin staining and mucin immunostainings (MUCs 1, 2, 5AC, and 6).
  
  
  METHODS
  Single-center, prospective study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  The sensitivity and specificity of cytology were assessed. The agreement between cytological and histological results for MUC was also examined.
  
  
  RESULTS
  Cytology with this method was investigated in 44 patients. Cell block diagnosis was cancer positive (class V or IV) in 11 patients and negative (classes I, II, III, and noninformative) in 33. The sensitivity, specificity, and positive and negative predictive values of this method were 92%, 100%, 100%, and 97%, respectively. The cytological and histological results of MUCs 1, 2, 5AC, and 6 agreed in 88% (15/17), 94% (16/17), 88% (15/17), and 100% (17/17), respectively.
  
  
  CONCLUSIONS
  Single center and small number of patients.
  
  
  CONCLUSIONS
  Pancreatic duct lavage cytology with the cell block method may be useful to differentiate between benign and malignant IPMNs preoperatively and as well as to determine their mucin type.
authors.affiliation: Department of Gastroenterology, Juntendo University, Tokyo, Japan. jinkans@juntendo.ac.jp
authors.forename: Jin Kan
authors.initials: JK
authors.lastname: Sai
authors.forename: Bunsei
authors.initials: B
authors.lastname: Nobukawa
authors.forename: Yuuji
authors.initials: Y
authors.lastname: Matsumura
authors.forename: Sumio
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D003581:Cytodiagnosis; D016145:Endoscopy, Digestive System; D019160:Endosonography; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000276:immunology; D018297:Neoplasms, Cystic, Mucinous, and Serous / Q000000981:diagnostic imaging / Q000473:pathology*; D010183:Pancreatic Ducts / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D011237:Predictive Value of Tests; D007507:Therapeutic Irrigation
chemical_list: D009077:Mucins