■用于报告胰胆管细胞学的Papanicolaou细胞病理学学会(PSCPC)是对胰腺细针穿刺细胞学(FNAC)涂片进行分类的可靠方法。然而,并不是没有实际问题会降低细胞学诊断的诊断准确性。
■为了确定诊断缺陷,同时根据PSCPC报告胰腺病变的细胞形态学,将FNAC发现与组织病理学相关联。
■对我们三级保健研究所病理学系2年的胰腺FNAC涂片进行了回顾性分析。细胞学诊断根据Papanicolaou细胞病理学学会报告胰胆管细胞学系统进行分类,并与组织病理学相关。分析细胞组织学不一致的原因。
■在50例同时进行FNAC和胰腺病变活检的病例中,34例阳性/恶性(VI类),8例可疑为恶性肿瘤(V类),3例肿瘤(IV类),2例不典型(III类),2例恶性肿瘤阴性(II类),1例非诊断性(I类)。在50个案例中,6例患者由于材料不足,组织病理学无法诊断.其余44例患者的细胞学诊断与组织病理学进行了比较。第三类,IVV,VI被认为是肿瘤病理学阳性。FNAC预测肿瘤病理的敏感性为97.5%,而特异性为25%。阳性预测值为92.9%。报告为非典型(III类)的两例病例在组织病理学上被证明是腺癌。1例细胞学报告为神经内分泌肿瘤,2例报告为腺癌,组织学上表现为慢性胰腺炎。1例报告为肿瘤性粘液性囊肿(IV类),经组织学证实为腺癌(一致性有限)。
■细胞病理学家需要警惕潜在的陷阱,以提高FNAC的诊断准确性。
UNASSIGNED: The Papanicolaou Society of Cytopathology System for reporting Pancreaticobiliary Cytology (PSCPC) is a reliable method to classify pancreatic fine needle aspiration cytology (FNAC) smears. However, it is not without practical problems which can diminish the diagnostic accuracy of the cytological diagnosis.
UNASSIGNED: To determine the diagnostic pitfalls while reporting cytomorphology of pancreatic lesions according to PSCPC on correlating FNAC findings with histopathology.
UNASSIGNED: Retrospective analysis of pancreatic FNAC smears received in the Department of Pathology of our tertiary care institute over a period of 2 years was done. The cytological diagnoses were classified according to the Papanicolaou Society of Cytopathology system of reporting pancreaticobiliary cytology and correlated with histopathology. The reasons of cyto-histological discordance were analyzed.
UNASSIGNED: Out of 50 cases in which both FNAC and biopsy of pancreatic lesions were done, 34 cases were positive/malignant (Category VI), eight cases were suspicious for malignancy (Category V), three cases were
neoplastic (Category IV), two cases were atypical (Category III), two cases were negative for malignancy (Category II), and one case was non-diagnostic (Category I). Out of 50 cases, histopathology was non-diagnostic due to inadequate material in six cases. The cytological diagnoses were compared with histopathology in the remaining 44 cases. Categories III, IV V, and VI were considered as positive for
neoplastic pathology. The sensitivity of FNAC to predict
neoplastic pathology was 97.5%, while the specificity was 25%. The positive predictive value was 92.9%. Two cases reported as atypical (Category III) turned out to be adenocarcinoma on histopathology. One case reported as neuroendocrine tumor and two cases reported as adenocarcinoma on cytology displayed features of chronic pancreatitis on histology. One case reported as
neoplastic mucinous cyst (Category IV) turned out to be adenocarcinoma on histology (limited concordance).
UNASSIGNED: The cytopathologist needs to be wary of the potential pitfalls to improve the diagnostic accuracy of FNACs.