False Negative and False positive Rates in Common Bile Duct Brushing Cytology, a Single Center Experience

Bita Geramizadeh, Maryam Moughali, Atefeh Shahim-Aein, Soghra Memari, Ziba Ghetmiri, Alireza Taghavi, Kamran Bagheri-Lankarani

Abstract


54

Aim: In this study we tried to find out the accuracy of biliary tract brushing cytology in our center as the largest referral center in the
south of Iran.
Background: Common bile duct brushing cytology has been introduced as the method of choice for the diagnosis of
pancreaticobiliary malignancies. However, there have been controversial reports about the sensitivity, specificity and overall accuracy
of this method in the English literature.
Methods: During the study period (2012-2016) there has been 166 cases of common bile duct brushing cytology taken during
endoscopic retrograde cholangiopancreatography (ERCP). One case has been excluded because of inadequate number of cells in the
cytology smear. All the smears have been stained by routine cytologic stains and screened by cytotechnologists and diagnosed by
expert cytopathologist. Final diagnosis by biopsy has been considered as the gold standard.
Results: According to the final histologic diagnosis as the gold standard, there were 22 false negative and 7 false positive cases. All of
the false positive cases have been suspected cases in the background of primary sclerosing cholangitis. The most common final
diagnosis of false negative cytologic diagnoses has been intrahepatic cholangiocarcinoma in which no malignant cell has been
identified in the presence of adequate number of normal ductal epithelial cells.
Conclusion: Common bile duct brushing cytology is the method of choice for the diagnosis of pancreaticobiliary tract malignancies;
however, having high specificity (90%), the sensitivity is low (56%). Cytologic diagnosis of biliary tract malignancies should be
made with caution in the patients with primary sclerosing cholangitis. Also it is important to know that high false negative rate is
present in common bile duct brushing cytology especially in the cases of intrahepatic cholangiocarcinoma without extension into
extrahepatic ducts.
Keywords: Brush cytology, Common bile duct
(Please cite as: Geramizadeh B, Moughali M, Shahim-Aein A, Memari S, Ghetmiri Z, Taghavi A, et al. False
negative and false positive rates in common bile duct brushing cytology, a single center experience.
Gastroenterol Hepatol Bed Bench 2018;11(4):296-300).


 


Full Text:

PDF - View Count=11

References


Volmar KE, Vollmer RT, Routbort MJ, Creager AJ. Pancreatic and bile duct brushing cytology in 1000 cases. Review of findings and comparison of preparation methods. Mod Pathol. 2005; 18 :79A.

Siddiqui MT, Gokaslan ST, Saboorian MH, Carrick K, Ashfaq R.Comparison of ThinPrep and Conventional Smears in Detecting Carcinoma in Bile Duct Brushings

Cancer Cytopathol 2003;99: 205–10.

Mahmoudi N, Enns R, Amar J, AlAli J, Lam E, Telford J. Biliary brush cytology: Factors associated with positive yields on biliary brush cytology. World J Gastroenterol 2008 January 28; 14: 569-573.

Logrono R, Kurtycz DF, Molina CP, Trivedi VA, Wong JY, Block KP. Analysis of false-negative diagnoses on endoscopic brush cytology of biliary and pancreatic duct strictures. The experience at 2 university hospitals. Arch Pathol Lab Med 2000;124: 387–392.

Stewart CJR, Mills PR, Carter R, O’Donohue J, Fukkarton G, Imrie CW, Murray WR. Brush cytology in the assessment of pancreatico–biliary strictures: a review of 406 cases. J Clin Pathol 2001;54: 449–455.

Xing GS, Geng JC, XW H, Dai JH, Wu CY. Endobiliary brush cytology during percutaneous transhepatic cholangiodrainage in patients obstructive jaundice. Hepatobiliary Pancreat Dis Int 2005;4:98-103.

Renshaw AA, Madge R, Jiroutek M, Granter SR. Bile duct brushing cytology: Statistical analysis of proposed diagnostic criteria. American Journal of Clinical Pathology 1998; 110: 635–640.

De Peralta-Venturina MN, Wong DK, Purslow MJ, Kini SR, Biliary tract cytology in specimens obtained by direct cholangiographic procedures: A study of 74 cases.

Diagn Cytopathol 1996;14:334–348.

Layfield LJ, Cramer H.Primary sclerosing cholangitis as a cause of false positive bile duct brushing cytology: Report of two cases. Diagn Cytopathol. 2005;32: 119–124.

Nishikawa T, Tsuyuguchi T, Sakai Y, Sugiyama H, Tawada K, Mikata R, Tada M, Ishihara T, Miyazaki M, Yokosuka O. Factors affecting the accuracy of endoscopic transpapillary sampling methods for bile duct cancer. Dig Endosc. 2014 ;26:276-81.

Schoefl R, Haefner M, Wrba F, Pfeffel F, Stain C, Poetzi R, Gangl A. Forceps biopsy and brush cytology during endoscopic retrogradecholangiopancreatography for the diagnosis of biliary stenoses. Scand J Gastroenterol. 1997 ;32:363-8.

Fogel EL, deBellis M, McHenry L, Watkins JL, Chappo J, Cramer H, Schmidt S, Lazzell-Pannell L, Sherman S, Lehman GA.Effectiveness of a new long cytology brush in the evaluation of malignant biliaryobstruction: a prospective study. Gastrointest Endosc. 2006 ;63:71-7.

DeWitt J1, Misra VL, Leblanc JK, McHenry L, Sherman S.EUS-guided FNA of proximal biliary strictures after negative ERCP brush cytologyresults. Gastrointest Endosc. 2006;64:325-33.

Kitajima Y, Ohara H, Nakazawa T, Ando T, Hayashi K, Takada H, Tanaka H, Ogawa K, Sano H, Togawa S, Naito I, Hirai M, Ueno K, Ban T, Miyabe K, Yamashita H, Yoshimura N, Akita S, Gotoh K, Joh T.Usefulness of transpapillary bile duct brushing cytology and forceps biopsy for improved diagnosis in patients with biliary strictures. J Gastroenterol Hepatol. 2007 Oct;22(10):1615-20.

Boberg KM, Jebsen P, Clausen OP, Foss A, Aabakken L, Schrumpf E.

Diagnostic benefit of biliary brush cytology in cholangiocarcinoma in primary sclerosing cholangitis. J Hepatol. 2006 Oct;45:568-74.

Govil H, Reddy V, Kluskens L, Treaba D, Massarani-Wafai R, Selvaggi S, Gattuso P.Brush cytology ofthe biliary tract: retrospective study of 278 cases with

histopathologic correlation. Diagn Cytopathol. 2002 ;26:273-7.

Harewood GC, Baron TH, Stadheim LM, Kipp BR, Sebo TJ, Salomao DR.Prospective, blinded assessment of factors influencing the accuracy of biliary cytology interpretation. Am J Gastroenterol. 2004;99:1464-9.




DOI: https://doi.org/10.22037/ghfbb.v11i4.1315

Creative Commons License
GHFBB by Gastroenterology and Liver Diseases Research Institute is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

 

PISSN: 2008-2258

EISSN: 2008-4234


•  

Privacy Policy | For Author | Online Submission | About | Contact

Copyright © 2018 Shahid Beheshti University of Medical Sciences. All rights reserved.