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Titolo:
Adenocarcinoma in colonic brushing cytology: High-grade dysplasia as a diagnostic pitfall
Autore:
Yu, GH; Nayar, R; Furth, EE;
Indirizzi:
Univ Penn, Med Ctr, Dept Pathol & Lab Med, Cytopathol Sect, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 thol Sect, Philadelphia, PA 19104 USA
Titolo Testata:
DIAGNOSTIC CYTOPATHOLOGY
fascicolo: 5, volume: 24, anno: 2001,
pagine: 364 - 368
SICI:
8755-1039(200105)24:5<364:AICBCH>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
FINE-NEEDLE ASPIRATION; BIOPSY; CANCER; LUNG; ACCURACY;
Keywords:
cytopathology; colon; adenocarcinoma;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Yu, GH Univ Penn, Med Ctr, Dept Pathol & Lab Med, Cytopathol Sect, 3400 Spruce St,6 Founders Pavilion, Philadelphia, PA 19104 USA Univ Penn 3400 Spruce St,6 Founders Pavilion Philadelphia PA USA 19104
Citazione:
G.H. Yu et al., "Adenocarcinoma in colonic brushing cytology: High-grade dysplasia as a diagnostic pitfall", DIAGN CYTOP, 24(5), 2001, pp. 364-368

Abstract

Cytologic evaluation of brushing specimens obtained from the colon may be useful in the diagnosis of neoplastic and inflammatory lesions, as previousstudies have reported favorable sensitivity and specificity figures for this procedure. In this study, we report our experience with 80 colonic brushings examined over a 5-yr period. Thirty cases received an atypical or malignant cytologic diagnosis. Nineteen of 20 cases diagnosed cytologically as adenocarcinoma revealed adenocarcinoma on biopsy; one case showed only adenomatous epithelium on biopsy and subsequent resection. Cases diagnosed cytologically as "atypical" or "adenomatous" showed adenocarcinoma, adenoma, and inflammatory conditions upon biopsy. Slides from 30 atypical/malignant cases were retrospectively reviewed for a number of cytomorphologic features and were correlated with the histologic diagnosis. Cases from histologically confirmed adenocarcinoma tended to show greater degrees of altered nuclear polarity, nuclear pleomorphism, membrane irregularities, and chromatin pattern alterations than those from histologically proven adenomatous or inflammatory lesions. The most likely cause of a false-positive diagnosis in this setting is sampling of an adenoma with high-grade dysplasia which fails to meet histologic criteria for adenocarcinoma (invasion of the underlying muscularis mucosae). Thus, in the second part of the study, we examined histologic sections from surgically excised adenomas to determine the frequency with which profound nuclear atypia is at least focally present, potentially resulting in a false-positive cytology diagnosis upon brushing. Slides from 51 cases were reviewed; cytologic atypia beyond that typically observed in adenomas was not observed in 43% of cases. However, profound nuclear atypia was present in 6% of cases; cytologic evaluation of a brushing specimen from these lesions may have resultedin a false-positive diagnosis of adenocarcinoma, despite the histologic diagnosis of adenoma with severe dysplasia. The remaining cases demonstrated intermediate degrees of atypia. These findings serve to quantitate the frequency with which cytohistologic discrepancies might be expected for mass lesions of the colon. (C) 2001 Wiley-Liss, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/04/20 alle ore 07:36:03