Gastrointestinal Cytology

  • Gabriela Oprea-IliesEmail author
  • Momin T. Siddiqui
Part of the Atlas of Anatomic Pathology book series (AAP)


Cytology of the gastrointestinal (GI) tract, with a relatively timid start, continues to develop due to the use of flexible endoscopy. Cytology specimens can be obtained as exfoliative cytology from the oral cavity to the stomach and also from the anorectal area, using brushes, abrasive balloons, and lavage. Fine-needle aspiration (FNA) specimens obtained with flexible endoscopes, aided by high-resolution ultrasound probe, allow for real-time visualization and sampling of lesions of the four layers of the GI tract. As in most areas, cytology specimens and biopsy specimens are complementary and increase sensitivity and specificity in diagnosing GI lesions. Although GI cytology/endoscopy is not yet used for mass screening, one can foresee a time when this is going to change, similar to existing screening programs for pulmonary and airway lesions. Currently, only screening for anorectal squamous intraepithelial lesions is ongoing, with well-determined reporting criteria. GI cytology can be used to diagnose infectious processes and malignancy in immunocompromised patients, and it could be used in surveillance of patients with Barrett’s esophagus or with inflammatory bowel diseases. Being acquainted with the type of cells that normally line the GI tract—basically squamous and glandular cells—and with its wide possible pathology, the cytopathologist is an essential player in the clinical management team. In addition, tissue obtained by FNA as fresh specimens or cell blocks will surely be used for additional molecular studies in the era of molecular testing and personalized medicine.


Brush cytology Balloon abrasive cytology Salvage cytology Oropharyngeal carcinoma Esophageal cytology Herpes esophagitis Barrett’s esophagus surveillance Squamous cell carcinoma of the esophagus Adenocarcinoma of the esophagus Gastric adenocarcinoma Neuroendocrine tumors of the stomach Gastric lymphoma Gastrointestinal stromal tumor cytology Duodenal cytology Colon cytology Anal cytology Low-grade squamous intraepithelial lesion High-grade squamous intraepithelial lesion HPV testing in anal cytology 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pathology and laboratory MedicineEmory University School of MedicineAtlantaUSA
  2. 2.Weill-Cornell MedicineNew YorkUSA

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