Abstract
The diagnostic category “Suspicious for Malignancy” is utilized for endoscopic ultrasound fine-needle aspiration specimens obtained from solid lesions and brushing specimens of strictures containing cytologic features falling just short of those necessary for a definitive diagnosis of a high-grade malignancy (pancreatic ductal carcinoma, acinar carcinoma or metastasis). “Suspicious for Malignancy” is the appropriate category for brushing specimens with features of high-grade dysplasia (biliary intraepithelial neoplasia III). Specimens categorized as “Suspicious for Malignancy” have a high risk for malignancy. Fluorescence in situ hybridization (FISH) ancillary testing or next-generation sequencing may be appropriate to further define specimens placed in this category.
An erratum to this chapter can be found at http://dx.doi.org/10.1007/978-3-319-16589-9_9
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Logroño R, Wong JY. Reporting the presence of significant epithelial atypia in pancreaticobiliary brush cytology specimens lacking evidence of obvious carcinoma: impact on performance measures. Acta Cytol. 2004;48(5):613–21.
Elek G, Gyökeres T, Schäfer E, Burai M, Pintér F, Pap A. Early diagnosis of pancreatobiliary duct malignancies by brush cytology and biopsy. Pathol Oncol Res. 2005;11(3):145–55.
Mansfield JC, Griffin SM, Wadehra V, Matthewson K. A prospective evaluation of cytology from biliary strictures. Gut. 1997;40(5):671–7.
Stewart CJ, Mills PR, Carter R, O’Donohue J, Fullarton G, Imrie CW, Murray WR. Brush cytology in the assessment of pancreatico-biliary strictures: a review of 406 cases. J Clin Pathol. 2001;54(6):449–55.
Layfield LJ, Wax TD, Lee JG, Cotton PB. Accuracy and morphologic aspects of pancreatic and biliary duct brushings. Acta Cytol. 1995;39(1):11–8.
Pitman MB, Centeno BA, Ali SZ, Genevay M, Stelow E, Mino-Kenudson M, Fernandez-del Castillo C, Max Schmidt C, Brugge W, Layfield L. Standardized terminology and nomenclature for pancreatobiliary cytology: the papanicolaou society of cytopathology guidelines. Diagn Cytopathol. 2014;42(4):338–50.
Volmar KE, Vollmer RT, Routbort MJ, Creager AJ. Pancreatic and bile duct brushing cytology in 1000 cases: review of findings and comparison of preparation methods. Cancer. 2006;108(4):231–8.
Chadwick BE, Layfield LJ, Witt BL, Schmidt RL, Cox RN, Adler DG. Significance of atypia in pancreatic and bile duct brushings: follow-up analysis of the categories atypical and suspicious for malignancy. Diagn Cytopathol. 2014;42(4):285–91.
Layfield LJ, Schmidt RL, Hirschowitz SL, Olson MT, Ali SZ, Dodd LL. Significance of the diagnostic categories “atypical” and “suspicious for malignancy” in the cytologic diagnosis of solid pancreatic masses. Diagn Cytopathol. 2014;42(4):292–6.
Layfield LJ, Dodd L, Factor R, Schmidt RL. Malignancy risk associated with diagnostic categories defined by the papanicolaou society of cytopathology pancreaticobiliary guidelines. Cancer Cytopathol. 2014;122(6):420–7.
Cohen MB, Egerter DP, Holly EA, Ahn DK, Miller TR. Pancreatic adenocarcinoma: regression analysis to identify improved cytologic criteria. Diagn Cytopathol. 1991;7(4):341–5.
Cohen MB, Wittchow RJ, Johlin FC, Bottles K, Raab SS. Brush cytology of the extrahepatic biliary tract: comparison of cytologic features of adenocarcinoma and benign biliary strictures. Mod Pathol. 1995;8(5):498–502.
Nakajima T, Tajima Y, Sugano I, Nagao K, Sakuma A, Koyama Y, Kondo Y. Multivariate statistical analysis of bile cytology. Acta Cytol. 1994;38(1):51–5.
Renshaw AA, Madge R, Jiroutek M, Granter SR. Bile duct brushing cytology: statistical analysis of proposed diagnostic criteria. Am J Clin Pathol. 1998;110(5):635–40.
Huffman B, Layfield L, Esebua M, Witt B, Schmidt R. Risk stratification using cytomorphologic features in endoscopic-ultrasonographic guided fine needle aspiration diagnosis of pancreatic ductal adenocarcinoma. Diagnostic Cytopathology. DOI 10.1002/dc.
Lee JG, Leung JW, Baillie J, Layfield LJ, Cotton PB. Benign, dysplastic, or malignant–making sense of endoscopic bile duct brush cytology: results in 149 consecutive patients. Am J Gastroenterol. 1995;90(5):722–6.
Boldorini R, Paganotti A, Sartori M, Allegrini S, Miglio U, Orsello M, Veggiani C, Del Piano M, Monga G. Fluorescence in situ hybridisation in the cytological diagnosis of pancreatobiliary tumours. Pathology. 2011;43(4):335–9.
Kubiliun N, Ribeiro A, Fan YS, Rocha-Lima CM, Sleeman D, Merchan J, Barkin J, Levi J. EUS-FNA with rescue fluorescence in situ hybridization for the diagnosis of pancreatic carcinoma in patients with inconclusive on-site cytopathology results. Gastrointest Endosc. 2011;74(3):541–7.
Kato K, Kamada H, Fujimori T, Aritomo Y, Ono M, Masaki T. Molecular biologic approach to the diagnosis of pancreatic carcinoma using specimens obtained by EUS-guided fine needle aspiration. Gastroenterol Res Pract. 2012;2012:243524.
Layfield LJ, Ehya H, Filie AC, Hruban RH, Jhala N, Joseph L, Vielh P, Pitman MB. Utilization of ancillary studies in the cytologic diagnosis of biliary and pancreatic lesions: the papanicolaou society of cytopathology guidelines. Cytojournal. 2014;11(Suppl 1):4.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Pitman, M., Layfield, L. (2015). Category V: Suspicious (for Malignancy). In: The Papanicolaou Society of Cytopathology System for Reporting Pancreaticobiliary Cytology. Springer, Cham. https://doi.org/10.1007/978-3-319-16589-9_7
Download citation
DOI: https://doi.org/10.1007/978-3-319-16589-9_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-16588-2
Online ISBN: 978-3-319-16589-9
eBook Packages: MedicineMedicine (R0)