The Papanicolaou Society of Cytopathology System for Reporting Pancreaticobiliary Cytology

Pitman, Martha B.; Layfield, Lester J.

doi:10.1007/978-3-319-16589-9

Cited by 84 publications

(126 citation statements)

References 30 publications

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“…The clinical information of an intraluminal papillary mass could be a warning to avoid overcalling the cases with marked atypia as adenocarcinoma. According to The Papanicolaou Society of Cytopathology System for Reporting Pancreatobiliary Cytology, bile duct cytology uses the “atypical,” “suspicious,” and “malignant” categories and not the “neoplasia” category due to the lack of diagnostic criteria for premalignant biliary lesions. It is possible that IPNB cases will fall into the atypical or suspicious categories of the classification according to the degree of dysplasia found in the lesion.…”

Section: Resultsmentioning

confidence: 99%

Cytomorphology of intraductal papillary neoplasm of the biliary tract

Canepa

Yao

Nam

et al. 2019

Diagnostic Cytopathology

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Intraductal papillary neoplasms of the bile duct (IPNBs) are papillary epithelial proliferations with delicate fibrovascular cores within dilated bile ducts. They are thought to be premalignant lesions with potential to progress invasive tumors. To our knowledge, there are no prior descriptions of IPNB cytomorphology. A 58‐year‐old male presented with painless jaundice and elevated liver function tests was found to have an intraluminal mass within the left hepatic duct. A bile duct brushing diagnosed as “atypical cells present” showed a cellular specimen composed of papillary groups and linear strips of mostly cuboidal/columnar cells with mild atypia and vacuolated cytoplasm. A left hepatic lobectomy including extrahepatic bile ducts showed the mass consisted of papillary cores lined by pancreatobiliary‐type epithelium with mild‐to‐severe atypia, consistent with IPNB with a focus suspicious for invasion. The cytomorphologic features described in the current case suggest intraductal papillary neoplasm but may not be specific since similar features could be seen in other bile duct tumors and even in nonneoplastic conditions such as stent or cholelithiasis. However, it is worthwhile to report papillary hyperplasia with atypia in common bile duct brushings in order to avoid a false‐negative diagnosis, especially in the context of a filling defect by images which does not appear to be a stone.

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Section: Resultsmentioning

confidence: 99%

Cytomorphology of intraductal papillary neoplasm of the biliary tract

Canepa

Yao

Nam

et al. 2019

Diagnostic Cytopathology

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“…Additionally, interpretation can be difficult when the specimen contains a high amount of background mucin that can be confused with mucin-producing pancreatic cysts (IPMNs and MCNs). This phenomenon is not uncommonly encountered in daily practice, and it is more common with a transgastric approach than with a transduodenal approach when targeting the pancreatic cyst [18] . In this study, 10 (20%) of the SCAs had a mucinous background, while 6 (12%) had both mucinous epithelial fragments and a mucinous background.…”

Section: Discussionmentioning

confidence: 99%

“…This fact reflects the delicate nature of the epithelium lining the cysts that usually does not withstand the mechanical forces of direct smearing. Furthermore, the highly vascularized fibrous septa of SCAs often yield a hemorrhagic background with freefloating vascularized fibrous strands and scant cellularity [18] . In this regard, cytospin preparations of pancreatic cyst fluid aspiration are more often combined to yield diagnostic epithelial cells, and it is a good practice to save the needle rinse for cytospin preparation when the rapid on-site evaluation smears are hypocellular -especially when SCA is suspected.…”

Section: Discussionmentioning

confidence: 99%

Serous Cystadenoma of the Pancreas: Potentials and Pitfalls of a Preoperative Cytopathologic Diagnosis

et al. 2016

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Objectives: Pancreatic serous cystadenomas (SCAs) are benign tumors. Technological advances in imaging have led to increased recognition of asymptomatic pancreatic cysts, consequently increasing the demand for cytomorphologic evaluations of cyst fluid. Study Design: A retrospective search through the pathology archives over an 11-year period was performed to identify SCAs from pancreatectomy specimens with a presurgical pancreatic EUS-guided fine-needle aspiration (FNA). Results: Fifty-one FNAs were identified. The average patient age was 59.9 years and 34 (67%) were female. Thirty-five (69%) of the SCAs were located in the body or tail of the pancreas. SCAs ranged in size from 1.3 to 8.0 cm (mean 4.9). On imaging, features suggestive of SCA were seen in 7 (14%) cases. The cytologic diagnoses were as follows: SCA in 5 (10%) cases, suspicious for mucin-producing neoplastic cyst in 4 (8%), pseudocyst in 4 (8%), and benign ductal and/or acinar epithelium, not otherwise specified in 24 (47%). Additionally, 14 (27%) cases were deemed nondiagnostic. Conclusions: A cytopathologic diagnosis of SCA on FNA is extremely difficult. The salient cytomorphologic features for identifying SCAs included scant cellularity, a mostly clear background, absence of extracellular mucin, hemosiderin-laden macrophages, and loose fragments of cuboidal cells with a notable absence of necrosis, atypia, and mitoses.

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“…The categorization scheme for pancreaticobiliary cytology was based on 6 tiers and is shown in Table . A significant innovation centered around the creation of diagnostic terminology for lesions of uncertain malignant potential.…”

Section: The Papanicolaou Society System For Reporting Pancreaticobilmentioning

confidence: 99%

“…Lesions that do not clearly indicate their biologic behavior based on cytomorphology are placed in this category and have increased risk. The suspicious for malignancy category was reserved for worrisome samples that are somehow qualitatively or quantitatively deficient without sufficient features to make the call of cancer …”

Section: The Papanicolaou Society System For Reporting Pancreaticobilmentioning

confidence: 99%

Standardized terminology systems in cytopathology

Sundling¹,

Kurtycz²

2018

Diagnostic Cytopathology

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There has been increasing pressure for systemization in cytopathology. Lack of uniformity in categorization, variation in opinion based regional practice, and technologic advancement have created an environment disposed toward creation of more consistent evidence‐based approaches to diagnostic problems. This review provides an overview of the major standardized terminology systems in cytology, with historical perspectives and commentary on current uses of these systems. These systems now include gynecologic, thyroid, pancreaticobiliary, urinary, salivary gland, and breast cytology. We summarize major classification systems supported by national and international professional organizations, outlining the structure and goals of each system. Specific benefits and potential pitfalls in the implementation of each system are given. Finally, we address potential criticisms of standardized terminology systems and proposed future directions to continue the evolution of standardized terminology to improve clinical practice.

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The Papanicolaou Society of Cytopathology System for Reporting Pancreaticobiliary Cytology

Cited by 84 publications

References 30 publications

Cytomorphology of intraductal papillary neoplasm of the biliary tract

Cytomorphology of intraductal papillary neoplasm of the biliary tract

Serous Cystadenoma of the Pancreas: Potentials and Pitfalls of a Preoperative Cytopathologic Diagnosis

Standardized terminology systems in cytopathology

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