Post-brushing and fine-needle aspiration biopsy follow-up and treatment options for patients with pancreatobiliary lesions: The Papanicolaou Society of Cytopathology Guidelines

Abstract

The Papanicolaou Society of Cytopathology (PSC) has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) biopsy, techniques of EUS-FNA, terminology and nomenclature for pancreatobiliary cytology, ancillary testing and post-procedure management. All documents are based on the expertise of the authors, a review of the literature and discussions of the draft document at several national and international meetings over an 18 month period and synthesis of online comments of the draft document on the PSC web site (www.papsociety.org). This document selectively presents the results of these discussions and focuses on the follow-up and treatment options for patients after procedures performed for obtaining cytology samples for the evaluation of biliary strictures and solid and cystic masses in the pancreas. These recommendations follow the six-tiered terminology and nomenclature scheme proposed by committee III.

Suboptimal Interobserver Agreement Among Cytopathologists in Assessment of Pancreatic Lesions: A Call for Action

“…Modeling from the success of the Bethesda system for reporting cervical cytology in which the cytologists showed improvement over time in using the Bethesda system to achieve consensus in cervical cytology interpretation, 7 it is highly desirable for the cytopathology team to apply the recently proposed Bethesda style guidelines for reporting pancreaticobiliary cytology. [8][9][10][11][12] The guidelines not only consider diagnostic categories and criteria, but also attempt to provide details on other aspects including techniques for obtaining specimens, which patient would benefit most from cytologic evaluation, information on ancillary testing, and patient follow-up evaluation/management. A 6-tiered system is recommended for the standardized nomenclature in pancreaticobiliary cytology.…”