Abstract
Objectives : To investigate the cytomorphology of bile samples obtained from long-term indwelling percutaneous transhepatic cholangiodrainage (PTCD) tubes following bile duct surgery for benign diseases.
Study Design : We examined 12 bile duct washing samples obtained from long-term PTCD tubes in 5 patients. Cytologic evaluation was performed based on the “diagnostic bile cytology criteria” . As controls, we used 5 samples obtained from short-term (less than 6 hour) PTCD tubes of patients with cholangitis and 5 samples from patients with cholangiocarcinoma.
Results : The mean nuclear area of bile duct epithelial cells of the samples from long-term tubes was 24.8μm2. Anisokaryosis was observed in 4 samples (33.3%), and the mean nuclear area of these samples was 29.8 μm2. The mean nuclear area of the other 8 samples without anisokaryosis was 22.3μm2 (p<0.01). All 12 samples showed irregularly shaped groups of cells in a background of mucin. The samples with anisokaryosis also showed nuclear membrane irregularity and prominent nucleoli in addition to the irregular groups. The mean nuclear area of the 4 samples was smaller than carcinoma cases (p<0.01), and larger than the samples from short-term tubes (p<0.01).
Conclusion : Bile duct washing cytology samples from long-term PTCD tubes can be used as cytology specimens to exclude malignancy by using the “Diagnostic bile cytology criteria” and evaluating cell arrangements, nuclear membrane irregularity, and appearance of nucleoli, etc.
