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Cytohistological discordance on gastrointestinal brushings: Facts unfolded

View Article: PubMed Central - PubMed

ABSTRACT

Introduction:: Brush cytology is a rapid, cost-effective, and reliable tool to diagnose gastrointestinal tract (GIT) lesions in low-resource settings. Most of the studies on GIT brushings have focused on upper GI lesions. We have studied the diagnostic accuracy of brush cytology in the entire length of GIT and correlated the cytological diagnosis with histopathology. The aim of this study is to study diagnostic utility of brush cytology of GIT lesions in the context of correlation with biopsy and study the factors responsible for cytohistological discordance.

Materials and methods:: A retrospective analysis of 101 cases of prebiopsy brush cytology samples of GIT lesions was done over a period of 1 year (June 2014 to May 2015). The cytological diagnosis was compared with histopathological diagnosis and percentage of correlation was calculated. The reasons for discordance were noted and studied.

Results:: The cytological diagnosis of 79 (78.2%) correlated with histopathological diagnosis. There was discordance in cytological and histological diagnosis in 22 cases (21.8%). Inadequacy of cytological sample and overlap of nuclear atypia caused by regenerative changes and malignancy were significant factors for cytohistological discordance.

Conclusion:: The diagnostic accuracy of brush cytology can be improved by taking appropriate measures to eliminate factors responsible for fallacies in cytological diagnosis.

No MeSH data available.


Related in: MedlinePlus

Photomicrograph showing (a) spores and pseudohyphae of Candida in esophageal brushings (H and E, ×400); (b) epithelioid granuloma in colonic brushing. Inset showing Langhans giant cell (H and E, ×400); (c) colonic brushings in a case of adenocarcinoma showing pleomorphic tumor cells with nuclear overlapping (H and E, ×400); (d) adenocarcinoma colon with atypical mitotic figure (arrow) (H and E, ×400)
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Figure 1: Photomicrograph showing (a) spores and pseudohyphae of Candida in esophageal brushings (H and E, ×400); (b) epithelioid granuloma in colonic brushing. Inset showing Langhans giant cell (H and E, ×400); (c) colonic brushings in a case of adenocarcinoma showing pleomorphic tumor cells with nuclear overlapping (H and E, ×400); (d) adenocarcinoma colon with atypical mitotic figure (arrow) (H and E, ×400)

Mentions: There were two cases which were negative on both cytology as well as histopathology where cytology could detect Candida while the same was missed on histopathology [Figure 1a]. This can be attributed to superficial nature of Candida infection which is limited to just the epithelial cells which are readily detected by brush cytology.


Cytohistological discordance on gastrointestinal brushings: Facts unfolded
Photomicrograph showing (a) spores and pseudohyphae of Candida in esophageal brushings (H and E, ×400); (b) epithelioid granuloma in colonic brushing. Inset showing Langhans giant cell (H and E, ×400); (c) colonic brushings in a case of adenocarcinoma showing pleomorphic tumor cells with nuclear overlapping (H and E, ×400); (d) adenocarcinoma colon with atypical mitotic figure (arrow) (H and E, ×400)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036302&req=5

Figure 1: Photomicrograph showing (a) spores and pseudohyphae of Candida in esophageal brushings (H and E, ×400); (b) epithelioid granuloma in colonic brushing. Inset showing Langhans giant cell (H and E, ×400); (c) colonic brushings in a case of adenocarcinoma showing pleomorphic tumor cells with nuclear overlapping (H and E, ×400); (d) adenocarcinoma colon with atypical mitotic figure (arrow) (H and E, ×400)
Mentions: There were two cases which were negative on both cytology as well as histopathology where cytology could detect Candida while the same was missed on histopathology [Figure 1a]. This can be attributed to superficial nature of Candida infection which is limited to just the epithelial cells which are readily detected by brush cytology.

View Article: PubMed Central - PubMed

ABSTRACT

Introduction:: Brush cytology is a rapid, cost-effective, and reliable tool to diagnose gastrointestinal tract (GIT) lesions in low-resource settings. Most of the studies on GIT brushings have focused on upper GI lesions. We have studied the diagnostic accuracy of brush cytology in the entire length of GIT and correlated the cytological diagnosis with histopathology. The aim of this study is to study diagnostic utility of brush cytology of GIT lesions in the context of correlation with biopsy and study the factors responsible for cytohistological discordance.

Materials and methods:: A retrospective analysis of 101 cases of prebiopsy brush cytology samples of GIT lesions was done over a period of 1 year (June 2014 to May 2015). The cytological diagnosis was compared with histopathological diagnosis and percentage of correlation was calculated. The reasons for discordance were noted and studied.

Results:: The cytological diagnosis of 79 (78.2%) correlated with histopathological diagnosis. There was discordance in cytological and histological diagnosis in 22 cases (21.8%). Inadequacy of cytological sample and overlap of nuclear atypia caused by regenerative changes and malignancy were significant factors for cytohistological discordance.

Conclusion:: The diagnostic accuracy of brush cytology can be improved by taking appropriate measures to eliminate factors responsible for fallacies in cytological diagnosis.

No MeSH data available.


Related in: MedlinePlus