2023 Volume 62 Issue 1 Pages 10-16
Objective : The aim of this study was to clarify the significance of discordance between the cytological diagnosis and histopathological diagnosis in biliary tract cytology specimens obtained using the Trefle® device.
Study Design : We investigated the results of biliary cytology in specimens obtained using the Trefle® device from cases of biliary tract stenosis between 2014 and 2019. Specimens were collected from a total of 252 cases, including 46 cases of benign bile duct stenosis and 206 cases of malignant bile duct stenosis. Cases of mismatch between the cytological diagnosis and histological diagnosis in samples obtained at the same time using the same device were reviewed.
Results : A total of 21 cases (8.3% of all cases), including 11 cytologically negative and histologically positive (C−H+) cases, and 10 cytologically positive and histologically negative (C+H−) cases were reviewed. Among the 11 C−H+cases, 8 were cases of well-differentiated adenocarcinoma, and 2 were cases of high-grade BilIN. In contrast, among the 10 C+H− cases, 6 were cases of pancreatic cancer with submucosal invasion of the biliary tract.
Conclusion : Mismatch between the cytological diagnosis and histological diagnosis may be observed in biliary tract cytology specimens obtained using the Trefle® device. Attention must be paid to pseudonegative results of cytology in cases of well-differentiated adenocarcinoma of the biliary tract. In addition, in C+H− cases, one must take into account the possibility of pancreatic cancer with submucosal invasion of the biliary tract.
