Cytohistological discordance on gastrointestinal brushings: Facts unfolded.
BACKGROUND
Brush cytology is a rapid, cost-effective, and reliable tool to diagnose gastrointestinal tract (GIT) lesions in low-resource settings. Most of the studies on GIT brushings have focused on upper GI lesions. We have studied the diagnostic accuracy of brush cytology in the entire length of GIT and correlated the cytological diagnosis with histopathology. The aim of this study is to study diagnostic utility of brush cytology of GIT lesions in the context of correlation with biopsy and study the factors responsible for cytohistological discordance.


METHODS
A retrospective analysis of 101 cases of prebiopsy brush cytology samples of GIT lesions was done over a period of 1 year (June 2014 to May 2015). The cytological diagnosis was compared with histopathological diagnosis and percentage of correlation was calculated. The reasons for discordance were noted and studied.


RESULTS
The cytological diagnosis of 79 (78.2%) correlated with histopathological diagnosis. There was discordance in cytological and histological diagnosis in 22 cases (21.8%). Inadequacy of cytological sample and overlap of nuclear atypia caused by regenerative changes and malignancy were significant factors for cytohistological discordance.


CONCLUSIONS
The diagnostic accuracy of brush cytology can be improved by taking appropriate measures to eliminate factors responsible for fallacies in cytological diagnosis.
Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Ruchita
R
Tyagi
Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Jagpal
J
Kaur
Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Gursheen
G
Kaur
Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Pavneet Kaur
PK
Selhi
Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Harpreet Kaur
HK
Puri
Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Neena
N
Sood
Brushings; cytology; discordance; gastrointestinal