ACCURACY AND MORPHOLOGIC ASPECTS OF PANCREATIC AND BILIARY DUCT BRUSHINGS

One hundred eight brushing cytology specimens with adequate follow-tip were obtained from strictures of the biliary and pancreatic ducts. Th e material was classified as benign, reactive, low grade dysplasia, hi gh grade dysplasia or adenocarcinoma. A diagnosis of carcinoma was mad e in 18 patients, high grade dysplasia in 12, low grade dysplasia in 6 and benign, nonneoplastic in the remaining cases. The diagnostic sens itivity for carcinoma was 44%, with a specificity of 98%. Ten of 12 pa tients with high grade dysplasia demonstrated other evidence of carcin oma. No complications were encountered. Brushing cytodiagnosis of extr ahepatic biliary and pancreatic duct strictures appears to be a safe p rocedure, with high specificity but only modest sensitivity.