Cytology is a widely performed technique in evaluating biliary and pancreatic ductal lesions. The contribution of cytological methods to the diagnosis of the disorders causing biliary stricture, and biopsy diagnoses of the cases were evaluated together with clinical follow-up outcomes and the results presented in this study.
From January 2005 to December 2006, in Zonguldak Karaelmas University, Faculty of Medicine, Department of Gastroenterology, 20 biliary endoscopic brush cytology and 2 exfoliative cytology specimens from patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) and also biopsy materials of these 12 cases were evaluated under the guidance of clinical follow-up results.
Seventeen of the cytologic materials were diagnosed as benign, while 3 of them were suspect malignant and 2 of them were malignant. When the histopathological and cytological diagnoses of these 12 cases were compared, 6 of the 10 cases with cytologically “benign” diagnoses were confirmed histopathologically, while the remaining 4 were re-diagnosed as malignant. Also cytologically established 2 suspect malignant cases were histopathologically re-diagnosed as malignant. When the clinical follow-up data and the cytological diagnosis of 10 cases were compared, 5 of the 7 benign cases were followed up as “benign stricture” according to clinical and radiologic findings. Cytologically 2 cases diagnosed as benign, 1 case with a diagnosis of suspect malignant and 2 malignant cases were referred to Oncology Clinics with the diagnosis of pancreatic carcinoma.
Cytologic examinations performed during ERCP are non-invasive and diagnostically valuable methods. Although assessments of positive cytology results can be reliable in non-biopsied cases, negative results should not exclude malignancy.