Biliary Tract Malignancy

Bile Duct Brushings

September 2011

Obtaining bile duct brush cytologic specimens is the usual approach for distinguishing malignant from benign pancreatobiliary strictures. Bile duct strictures are obtained for cytology during endoscopic retrograde cholangiopancreatography or ERCP. The bile duct brushing cytology is important since it is sometimes able to provide a positive diagnosis for cases in which biopsies are negative or often inadequate. These specimens are obtained by passing an endoscope orally down to the level of the ampulla. The instrument used in this technique is a side-viewing instrument, allowing access to the ampulla. The ampulla is cannulated and a wire brush can be passed up the appropriate duct for obtaining cytologic specimens via the brush approach.

< Previous Slide

Bile Duct Brushings

Next Slide >

 

Jump to section:

• Introduction
• Disclosures
• Pancreatobiliary Strictures (PBS)
• Primary Sclerosing Cholangitis (PSC)
• Pancreatobiliary Strictures (PBS)
• Bile Duct Brushings
• Current Clinical Practice
• Factors That Influence Sensitivity Of Cytology Specimens
• Routine Cytology
• Cancer Is A Genetic Disorder That Results From Mutations
• Detecting Tumor Cells in Cytology Specimens Using FISH
• Types of FISH Probes
• FISH
• Sensitivity and Specificity of Various Tests for Detection of Pancreatobiliary Strictures Malignancy
• What Do We Do With These Data?
• Bile Duct Pathology Calculator
• Representative Test Report Using Bile Duct Calculator
• Bile Duct Calculator
• Impact of Disease Prevalence on Positive Predictive Value (PPV)
• Case 1
• Case 1 Cytologic Findings
• Case 1
• Case 1 Test Report Using Bile Duct Calculator
• Case 1
• Case 1
• Case 2
• Case 2 Cytologic Findings
• Case 2
• Case 2: Test Report Using Bile Duct Calculator
• Case 2
• Case 2
• Case 3
• Case 3 Cytologic Findings
• Case 3
• Case 3
• Case 3: Test Report Using Bile Duct Calculator
• Case 3
• Case 3
• Summary
• Summary
• Results
• Questions?