Abstract
Objective : To differentiate between benign and malignant, conditions, we studied bile cytology and possibly determining histopathological structure from cytology alone.
Study Design : Subjects were 45 suspicious cases from 1,627 specimens diagnosed between 1999 and 2008 for which we assessed cytological variables in bile cytology for irregular nuclear overlapping, nuclear arrangement, and cell clusters. We also studied nuclear enlargement, abnormal chromatin, anisokaryosis, nucleoli, necrotic background, and the presence of cell clusters. We then chose 26 surgical cases to further study bile duct carcinoma, histology, histological mucosal pattern, cell cluster appearance and cell atypia.
Results : Disordered nuclear arrangement, pleomorphism, and anisokaryosis occurred in bile duct carcinoma, unlike in benign cases, which showed no irregular cluster margin, abnormal chromatin, necrotic background, or cell cluster variations. Cytologically, where large and small cell clusters are the main constituent, the tall cylindrical configuration, must be considered, but when solitary cells are predominant, small cluster-like pattern must be considered. Mixed large or small clusters and solitary cells involve tall cylindrical, fused, or small cluster-like patterns. Cases of carcinomas with low-or high-grade atypia, however, showed no specific cytological or cell cluster features.
Conclusions : Benign or malignant cases judged by bile cytology alone based on cytological cell cluster findings, individual cells, and background must be carefully differentiated because the histopathological structure is difficult to evaluate using cytological findings alone.
