Journal of Cytology
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Year : 1998  |  Volume : 15  |  Issue : 1  |  Page : 49-58

Role of endoscopic cytology in gastrointestinal diseases

1 Department of Cytology & Gynaec Pathology, Postgraduate institute of Medical Education and Research, Chandigarh -160012. (India), India
2 Department of Histopathology, Postgraduate institute of Medical Education and Research, Chandigarh -160012. (India), India
3 Department of Gastroenterology, Postgraduate institute of Medical Education and Research, Chandigarh -160012. (India), India

Correspondence Address:
Subhash K Gupta
Prof and Head, Cytology Department, Postgraduate institute of Medical Education and Research, Chandigarh - 160 012
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Source of Support: None, Conflict of Interest: None

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One thousand three hundred and nintythree endoscopic G.I. cytology samples submitted for diagnosis between 1992-1996 were analysed. The sites of collection in order of frequency were : 846 gastric, 421 oesophageal, 91 colon and rectal and 35 duodenal. Brush cytology was used alone in 267. In the remaining multiple sampling methods such as imprint and crush smears with or without brush cytology and/or endoscopic suction cytology and FNAC smears were used. Biopsies for comparison were a vailable in all cases. The principal role of cytology was to rule out or confirm malignancy in a large majority of cases. Of the cases examined, 25% were reported as malignant and 66.5% as negative for malignant cells. Cytology was suggestive of malignancy in 3.9% and suspicious in 2.9%. Of the malignant cases as confirmed by histopathology, cytology gave a definite diagnosis of malignancy in 70% of squamous and adenocarcinoma (NOS) cases, in 78.7% poorly differentiated carcinoma cases, and in 45% of the signet ring cell carcinoma cases. Exact morphological subtyping of malignancy was possible in 60% of squamous cell carcinoma, 51.4% of adenocarcinoma and 71.4% of poorly differentiated carcinoma. None of the signet ring cell carcinoma cases could be specifically designated so. 90.6% of cases with suggestion of malignancy and 63.4% of cases with suspicious cytology were confirmed to be malignant. Of the eight histologically diagnosed NHL cases, cytology gave a diagnosis of NHL only in three of which two were high grade lymphoma. Cytology in addition picked up two more cases of NHL where the biopsy was non-committal to the diagnosis of NHL. Overall, although cytology missed the diagnosis of malignancy in 22.3% of cases, it also picked up 43 cases of malignancy which were missed on biopsy. Cytology also played a useful role in detecting H. pylori (positive correlation with histopathology: 74%), 3 cases of Candida, 4 cases of tuberculosis and one case of Barret's oesophagus which was clinically suspected to be carcinoma. Thus, endoscopic G.I. cytology is a useful adjunct to biopsy.

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