Intraoperative bile cytology of the dysplasia-carcinoma in situ sequence of gallbladder carcinoma

Cancer. 2005 Oct 25;105(5):277-81. doi: 10.1002/cncr.21320.

Abstract

Background: The preoperative diagnosis of noninvasive and early carcinoma of the gallbladder is considered to be both difficult and exceptional. In the current study, the authors conducted a cytologic analysis of bile in the intraoperative diagnosis of clinically unsuspected gallbladder carcinoma.

Methods: Bile samples collected from 40 patients at the time of elective cholecystectomy were centrifuged. Smears prepared from the sediments were stained with May-Grünwald-Giemsa and Papanicolaou stains. Lesions were categorized as hyperplasia with or without metaplasia, dysplasia, carcinoma in situ, and invasive carcinoma. Cytologic diagnoses were compared with histopathology.

Results: Two cases of carcinoma in situ and one case of invasive carcinoma diagnosed on bile cytology were confirmed by histopathology. No false-positive diagnoses were made based on cytologic examination of aspirated bile. Cytohistologic concordance in cases of hyperplasia, dysplasia, and chronic cholecystitis varied from 56-60%.

Conclusions: Intraoperative bile cytology was found to be a reliable method for the detection of in situ and early invasive carcinoma of the gallbladder.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Bile / cytology*
  • Carcinoma in Situ / diagnosis*
  • Carcinoma in Situ / pathology*
  • Carcinoma in Situ / surgery
  • Cholecystectomy
  • False Positive Reactions
  • Female
  • Gallbladder / pathology
  • Gallbladder Neoplasms / diagnosis*
  • Gallbladder Neoplasms / pathology*
  • Gallbladder Neoplasms / surgery
  • Humans
  • Intraoperative Period
  • Male
  • Middle Aged
  • Sensitivity and Specificity