Pancreas, Extrahepatic Bile Ducts, Ampullary Region

  • Peter Spieler
  • Matthias Rössle
Part of the Essentials of Diagnostic Pathology book series (ESSENTPATH)

Abstract

In section ‘Fine needle aspiration biopsy of Pancreas’ specific interest is directed towards (1) diagnostic procedures such as endoscopic ultrasound-guided FNAB and pancreaticobiliary duct brushing, (2) advantage and disadvantage of liquid-based cytology, (3) benefit of additive DNA ploidy analysis, (4) non-tumorous and neoplastic cystic disorders, (5) cytology of variably-differentiated ductal adenocarcinomas.

Section ‘Extrahepatic Bile ducts and Ampulla of Vater’ is primarily concerned with (1) benign cytology and the problem of contaminants in brushings, (2) regenerative and dysplastic change of ductal cells posing challenge in the cytologic workup, (3) cytology of adenocarcinomas.

Diagnostic algorithms of benign, borderline, and malignant findings in exfoliative and aspiration cytology and respective differential diagnoses are additionally presented in a synoptic setup.

Keywords

Bile Duct Primary Sclerosing Cholangitis Intraductal Papillary Mucinous Neoplasm Biliary Stricture Extrahepatic Bile Duct 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Further Reading

Further Reading (Sect. 10.1)

  1. 1.
    Adsay NV, Adair CF, Heffess CS, Klimstra DS. Intraductal oncocytic papillary neoplasms of the pancreas. Am J Surg Pathol 1996;20:980-994.PubMedGoogle Scholar
  2. 2.
    Adsay NV, Hasteh F, Cheng JD, et al. Lymphoepithelial cysts of the pancreas: a report of 12 cases and a review of the literature. Mod Pathol 2002;15:492-501.PubMedGoogle Scholar
  3. 3.
    Ahlawat SK, Lymphoepithelial cyst of pancreas. Role of endoscopic ultrasound guided fine needle aspiration. JOP 2008;9:230-234.PubMedGoogle Scholar
  4. 4.
    Alanen KA, Joensuu H, Klemi PJ, et al. DNA ploidy in pancreatic neuroendocrine tumors. Am J Clin Pathol 1990;93:784-788.PubMedGoogle Scholar
  5. 5.
    Al-Kaisi N, Weaver MG, Abdul KFW, et al. Fine needle aspiration cytology of neuroendocrine tumors of the pancreas. Acta Cytol 1992;36:655-660.PubMedGoogle Scholar
  6. 6.
    Alles AJ, Warshaw AL, Southern JF, et al. Expression of CA 72-4 (TAG-72) in the fluid contents of pancreatic cysts. A new marker to distinguish malignant pancreatic cystic tumors from benign neoplasms and pseudocysts. Ann Surg 1994;219:131-134.PubMedGoogle Scholar
  7. 7.
    Alpert LC, Truong LD, Bosart MI, et al. Microcystic adenoma (serous cystadenoma) of the pancreas. A study of 14 cases with immunohistochemical and electron microscopic correlation. Am J Surg Pathol 1988;12:251-263.PubMedGoogle Scholar
  8. 8.
    Alsibai KD, Denis B, Bottlaender J, et al. Impact of cytopathologist expert on diagnosis and treatment of pancreatic lesions in current clinical practice. A series of 106 endoscopic ultrasound-guided fine needle aspirations. Cytopathology 2006;17:18-26.PubMedGoogle Scholar
  9. 9.
    Andea A, Sarkar F, Adsay NV. Clinicopathologic correlates of pancreatic intraepithelial neoplasia: a comparative analysis of 82 cases with and 152 cases without pancreatic ductal adenocarcinoma. Mod Pathol 2003;16:996-1006.PubMedGoogle Scholar
  10. 10.
    Ardengh JC, Lopes CV, de Lima LF; et al. Diagnosis of pancreatic tumors by endoscopic ultrasound-guided fine-needle aspiration. World J Gastroenterol 2007;13:3112-3116.PubMedGoogle Scholar
  11. 11.
    Arvanitakis M, Van Laethem JL, Parma J, et al. Predictive factors for pancreatic cancer in patients with chronic pancreatitis in association with K-ras gene mutation. Endoscopy 2004;36:535-542.PubMedGoogle Scholar
  12. 12.
    Attasaranya S, Pais S, LeBlanc J, et al. Endoscopic ultrasoundguided fine needle aspiration and cyst fluid analysis for pancreatic cysts. JOP 2007;8:553-563.PubMedGoogle Scholar
  13. 13.
    Awadallah NS, Shroyer KR, Langer DA, et al. Detection of B7-H4 and p53 in pancreatic cancer: potential role as a cytological diagnostic adjunct. Pancreas 2008;36:200-206.PubMedGoogle Scholar
  14. 14.
    Ballas KD, Rafailidis SF, Demertzidis C, et al. Mixed exocrineendocrine tumor of the pancreas. JOP 2005;6:449-454.PubMedGoogle Scholar
  15. 15.
    Barabino M, Santambrogio P, Pisani A, et al. Endoscopic ultrasonography coupled with fine needle aspiration biopsy of intraductal papillary–mucinous tumours of the pancreas. Tool or gadget? A report of three cases. Chir Ital 2007;59:489-494.PubMedGoogle Scholar
  16. 16.
    Bardales RH, Centeno B, Mallery JS, et al. Endoscopic ultrasoundguided fine-needle aspiration cytology diagnosis of solid-pseudopapillary tumor of the pancreas: a rare neoplasm of elusive origin but characteristic cytomorphologic features. Am J Clin Pathol 2004;121:654-662.PubMedGoogle Scholar
  17. 17.
    Baron TH, Harewood GC, Rumalla A, et al. A prospective comparison of digital image analysis and routine cytology for the identification of malignancy in biliary tract strictures. Clin Gastroenterol Hepatol 2004;2:214-219.PubMedGoogle Scholar
  18. 18.
    Basir Z, Pello N, Dayer AM, et al. Accuracy of cytologic interpretation of pancreatic neoplasms by fine needle aspiration and pancreatic duct brushings. Acta Cytol 2003;47:733-738.PubMedGoogle Scholar
  19. 19.
    Bell DA. Cytologic features of islet-cell tumors. Acta Cytol 1987;31:485-492.PubMedGoogle Scholar
  20. 20.
    Belsley NA, Pitman MB, Lauwers GY, et al. Serous cystadenoma of the pancreas. Limitations and pitfalls of endoscopic ultrasoundguided fine-needle aspiration biopsy. Cancer(Cancer Cytopathol) 2008;114:102-110.Google Scholar
  21. 21.
    Berkel S, Hummel F, Gaa J, et al. Poorly differentiated small cell carcinoma of the pancreas. A case report and review of the literature. Pancreatology 2004;4:521-526.PubMedGoogle Scholar
  22. 22.
    Bhanot P, Nealon WH, Walser EM, et al. Clinical, imaging, and cytopathological features of solid pseudopapillary tumor of the pancreas: a clinicopathologic study of three cases and review of the literature. Diagn Cytopathol 2005;33:421-428.PubMedGoogle Scholar
  23. 23.
    Binek J, Abraham D, Borovicka J , Spieler P, et al. Endosonographic guided fine needle aspiration (EUS-FNA) in mediastinal and abdominal lesions: accuracy and patient tolerance. Gut 2004;53 (Suppl VI):A42.Google Scholar
  24. 24.
    Binek J, Lindenmann N, Meyenberger CM, Spieler P, et al. Malignant biliary stenosis: Conventional cytology versus DNA image cytometry. Surg Endosc 2011;25:1808-1813.PubMedGoogle Scholar
  25. 25.
    Binek J, Meyenberger C, Spieler P, et al. DNA-Image-Cytometry (ICM-DNA) of brush cytology for the diagnosis of malignant biliary tumors. Gastroenterology, Suppl1 2001;120:A-573.Google Scholar
  26. 26.
    Binek J, Spieler P, Hürlimann R, et al. Ultrasound-guided fineneedle aspiration of abdominal masses: accuracy and short-term complications. European Journal of Ultrasound 1995;2:199-203.Google Scholar
  27. 27.
    Bondeson L, Bondeson A-G, Grimelius L, Kjellström U. Oncocytic tumor of the pancreas. Report of a case with aspiration cytology. Acta Cytol 1990;34:425-428.PubMedGoogle Scholar
  28. 28.
    Brandwein SL, Farrell JJ, Centeno BA, Brugge WR. Detection and tumor staging of malignancy in cystic, intraductal, and solid tumors of the pancreas by EUS. Gastrointest Endosc 2001;53:722-727.PubMedGoogle Scholar
  29. 29.
    Bret PM, Nicolet V. Percutaneous fine-needle aspiration biopsy of the pancreas. Diagn Cytopathol 1986;2:221-227.PubMedGoogle Scholar
  30. 30.
    Buetow PC, Parrino TV, Buck Jl, et al. Islet cell tumors of the pancreas: Pathologic-imaging correlation among size, necrosis and cysts, calcification, malignant behaviour, and functional status. Am J Roentgenol 1995;165:1175.Google Scholar
  31. 31.
    Canto MI, Goggins M, Hruban RH, et al. Screening for early pancreatic neoplasia in high risk individuals: a prospective controlled study. Clin Gastroenterol Hepatol 2006 ;4:766-781.PubMedGoogle Scholar
  32. 32.
    Caudill JL, Humphrey SK, Salomao DR. Islet cell tumor of the pancreas. Increasing diagnosis after instituting ultrasonographyguided fine needle aspiration. Acta Cytol 2008;52:45-51.PubMedGoogle Scholar
  33. 33.
    Centeno BA, Pitman MB. Fine needle aspiration biopsy of the pancreas. Butterworth-Heinemann Boston Oxford 1999.Google Scholar
  34. 34.
    Chang KJ, Nguyen P, Erickson RA, et al. The clinical utility of endoscopic ultrasound-guided fine-needle aspiration in the diagnosis and staging of pancreatic carcinoma. Gastrointest Endosc 1997;45:387-393.PubMedGoogle Scholar
  35. 35.
    Chatelain D, Couvelard A, Hammel P, et al. Lympho-epithelial cyst of the pancreas: a difficult diagnosis. About two cases. Gastroenterol Clin Biol 2002;26:935-938.PubMedGoogle Scholar
  36. 36.
    Chatzipantelis P, Salla C, Konstantinou P, et al. Endoscopic ultrasound-guided Fine-needle aspiration cytology of pancreatic neuroendocrine tumors. A study of 48 cases. Cancer(Cancer Cytopathol) 2008;114:255-262.Google Scholar
  37. 37.
    Chetty R, Clark SP, Pitson GA. Primary small cell carcinoma of the pancreas. Pathology 1993;25:240-242.PubMedGoogle Scholar
  38. 38.
    Chopra S, Wu ML, Imagawa DK, et al. Endoscopic ultrasoundguided fine-needle aspiration of undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: a report of 2 cases with literature review. Diagn Cytopathol 2007;35:601-606.PubMedGoogle Scholar
  39. 39.
    Cohen MB, Egerter DP, Holly EA, et al. Pancreatic adenocarcinoma: regression analysis to identify improved cytologic criteria. Diagn Cytopathol 1991;7:341-345.PubMedGoogle Scholar
  40. 40.
    Collins BT, Cramer HM. Fine-needle aspiration cytology of islet cell tumors (review) Diagn Cytopathol 1996;15:37-45.PubMedGoogle Scholar
  41. 41.
    Collins BT, Agarwal B, Krishna NB, et al. Diagnostic value of endoscopic ultrasound fine needle aspiration in suspected pancreatic cancer patients with focal lesion on CT/MRI without obstructive jaundice. Cancer(Cancer Cytopathol) Suppl. 2007;111:418-419.Google Scholar
  42. 42.
    Colombo P, Arizzi C, Roncalli M. Acinar cell cystadenocarcinoma of the pancreas: report of rare cases and review of the literature. Hum Pathol 2004 ;35:1568-1571.PubMedGoogle Scholar
  43. 43.
    Compagno J, Oertel JE. Mucinous cystic neoplasms of the pancreas with overt and latent malignancy (cystadenocarcinoma and cystadenoma). A clinicopathologic study of 41 cases. Am J Clin Pathol 1978;69:573-580.PubMedGoogle Scholar
  44. 44.
    David O, Green L, Reddy V, et al. Pancreatic masses: a multi-institutional study of 364 fine-needle aspiration biopsies with histopathologic correlation. Diagn Cytopathol 1998;19:423-427.PubMedGoogle Scholar
  45. 45.
    Delatour NR, Policarpio-Nicolas MLC, Yazdi H, Islam S. Fine needle aspiration biopsy for preoperative workup of pancreatic cystic neoplasms. Report of 4 cases. Acta Cytol 2007;51:925-933.PubMedGoogle Scholar
  46. 46.
    DelMaschio A, Vanzulli A, Sironi S, et al. Pancreatic cancer versus chronic pancreatitis: diagnosis with CA 19-9 assessment, US, CT, and CT-guided fine-needle biopsy. Radiology 1991;178:95-99.PubMedGoogle Scholar
  47. 47.
    de Luna R, Eloubeidi MA, Sheffield MV, et al. Comparison of ThinPrep and conventional preparations in pancreatic fine-needle aspiration biopsy. Diagn Cytopathol 2004;30:71-76.PubMedGoogle Scholar
  48. 48.
    DeWitt J, Jowell P, Leblanc J, et al. EUS-guided FNA of pancreatic metastases: a multicenter experience. Gastrointest Endosc 2005;61:689-696.PubMedGoogle Scholar
  49. 49.
    Di Stasi M, Lencioni R, Solmi L, et al. Ultrasound-guided fine needle biopsy of pancreatic masses: results of a multicenter study. Am J Gastroenterol 1998;93:1329-1333.PubMedGoogle Scholar
  50. 50.
    Dodd LG, Evans DB, Symmans F, Katz RL. Fine-needle aspiration of pancreatic extramedullary plasmacytoma: possible confusion with islet cell tumor. Diagn Cytopathol 1994;10:371-374.PubMedGoogle Scholar
  51. 51.
    Duggan MA, Brasher P, Medlicott SA. ERCP-directed brush cytology prepared by the ThinPrep method: test performance and morphology of 149 cases. Cytopathology 2004;15:80-86.PubMedGoogle Scholar
  52. 52.
    Edoute Y, Lemberg S, Malberger E. Preoperative and intraoperative fine needle aspiration cytology of pancreatic lesions. Am J Gastroenterol 1991;86:1015-1019.PubMedGoogle Scholar
  53. 53.
    Eguchi H, Ishikawa O, Ohigashi H, et al. Role of intraoperative cytology combined with histology in detecting continuous and skip type intraductal cancer existence for intraductal papillary mucinous carcinoma of the pancreas. Cancer 2006;107:2567-2575.PubMedGoogle Scholar
  54. 54.
    Elek G, Gyökeres T, Schäfer E, et al. Early diagnosis of pancreatobiliary duct malignancies by brush cytology and biopsy. Pathol Oncol Res 2005;11:145-155.PubMedGoogle Scholar
  55. 55.
    Eloubeidi MA, Jhala D, Chhieng DC, et al. Yield of endoscopic ultrasound-guided fine-needle aspiration biopsy in patients with suspected pancreatic carcinoma. Cancer 2003;99:285-292.PubMedGoogle Scholar
  56. 56.
    Eloubeidi MA, Varadarajulu S, Desai S, et al. A prospective evaluation of an algorithm incorporating routine preoperative endoscopic ultrasound-guided fine needle aspiration in suspected pancreatic cancer. J Gastrointest Surg 2007;11:813-819.PubMedGoogle Scholar
  57. 57.
    Eloubeidi MA, Varadarajulu S, Desai S, Wilcox CM. Value of repeat endoscopic ultrasound-guided fine needle aspiration for suspected pancreatic cancer. J Gastroenterol Hepatol 2008;23:567-570.PubMedGoogle Scholar
  58. 58.
    Emerson L, Layfield LJ, Reiss R, et al. Malignant islet cell tumor with sarcomatous differentiation. Mod Pathol 2001;14:1187-1191.PubMedGoogle Scholar
  59. 59.
    Emerson RE, Randolph ML, Cramer HM. Endoscopic ultrasoundguided fine-needle aspiration cytology diagnosis of intraductal papillary mucinous neoplasm of the pancreas is highly predictive of pancreatic neoplasia. Diagn Cytopathol 2006;34:457-462.PubMedGoogle Scholar
  60. 60.
    Ettinghausen SE, Schwartzentruber DJ, Sindelar WF. Evolving strategies for the treatment of adenocarcinoma of the pancreas. A review. J Clin Gastroenterol 1995;21:48-60.PubMedGoogle Scholar
  61. 61.
    Fernandez-Cebrian JM, Carda P, Morales V, Galindo J. Dermoid cyst of the pancreas: a rare cystic neoplasm. Hepatogastroenterology 1998;45:1874-1876.PubMedGoogle Scholar
  62. 62.
    Ferreiro J, Lewin K, Herron RM, et al. Malignant islet cell tumor with rhabdomyosarcomatous differentiation. Am J Surg Pathol 1989;13:422-427.PubMedGoogle Scholar
  63. 63.
    Fischer HP, Altmannsberger M, Kracht J. Osteoclast-type giant cell tumor of the pancreas (review). Virchows Arch A 1988;412:247.Google Scholar
  64. 64.
    Fitzhugh VA, Mirani N, Aisner S, et al. Preoperative fine needle aspiration cytology diagnosis of microcystic adenoma of the pancreas: fact or fiction? A report of 2 cases. Acta Cytol 2008;52:240-246.PubMedGoogle Scholar
  65. 65.
    Fritscher-Ravens A, Brand L, Knöfel WT, et al. Comparison of endoscopic ultrasound-guided fine needle aspiration for focal pancreatic lesions in patients with normal parenchyma and chronic pancreatitis. Am J Gastroenterol 2002;97:2768-2775.PubMedGoogle Scholar
  66. 66.
    Fritscher-Ravens A, Sriram PVJ, Krause C, et al. Detection of pancreatic metastases by EUS-guided fine-needle aspiration. Gastrointest Endosc 2001;53:65-70.PubMedGoogle Scholar
  67. 67.
    Frossard JL, Amouyal P, Amouyal G, et al. Performance of endosonography-guided fine needle aspiration and biopsy in the diagnosis of pancreatic cystic lesions. Am J Gastroenterol 2003;98:1516-1524.PubMedGoogle Scholar
  68. 68.
    Garcea G, Ong SL, Rajesh A, et al. Cystic lesions of the pancreas. A diagnostic and management dilemma Pancreatology 2008;8:236-251.PubMedGoogle Scholar
  69. 69.
    Ghazale AH, Chari ST, Vege SS. Update on the diagnosis and treatment of autoimmune pancreatitis. Curr Gastroenterol Rep 2008;10:115-121.PubMedGoogle Scholar
  70. 70.
    Glasbrenner B, Ardan M, Boeck W, et al. Prospective evaluation of brush cytology of biliary strictures during endoscopic retrograde cholangiopancreatography. Endoscopy 1999;31:712-717.PubMedGoogle Scholar
  71. 71.
    Govil H, Reddy V, Kluskens L, et al. Brush cytology of the biliary tract: retrospective study of 278 cases with histopathologic correlation. Diagn Cytopathol 2002;26:273-277.PubMedGoogle Scholar
  72. 72.
    Graeme-Cook F, Bell DA, Flotte TJ, et al. Aneuploidy in pancreatic insulinomas does not predict malignancy. Cancer 1990;66:2365-2368.PubMedGoogle Scholar
  73. 73.
    Gress F, Gottlieb K, Sherman S, Lehman G. Endoscopic ultrasonography-guided fine-needle aspiration biopsy of suspected pancreatic cancer. Ann Intern Med 2001;134:459-464.PubMedGoogle Scholar
  74. 74.
    Griffin CA, Hruban RH, Morsberger LA, et al. Consistent chromosomal abnormalities in adenocarcinoma of the pancreas. Cancer Res 1995;55:2394-2399.PubMedGoogle Scholar
  75. 75.
    Hansen T, Burg J, Kirkpatrick CJ, et al. Osteoclast-like giant cell tumor of the pancreas with ductal adenocarcinoma: case report with novel data on histogenesis. Pancreas 2002;;25:317-319.PubMedGoogle Scholar
  76. 76.
    Hara H, Suda K. Review of the cytologic features of noninvasive ductal carcinomas of the pancreas: differences from invasive ductal carcinoma. Am J Clin Pathol 2008;129:115-129.PubMedGoogle Scholar
  77. 77.
    Hara H, Suda K, Oyama T. Cytologic study of noninvasive intraductal papillary-mucinous carcinoma of the pancreas. Acta Cytol 2002;46:519-526.PubMedGoogle Scholar
  78. 78.
    Hari S, Seith A, Srivastava DN, Makharia G, Pal S. Isolated tuberculosis of the pancreas diagnosed with needle aspiration: a case report and review of the literature. Trop Gastroenterol 2005;26:141-143.PubMedGoogle Scholar
  79. 79.
    Hernandez LV, Mishra G, Forsmark C, et al. Role of endoscopic ultrasound (EUS) and EUS-guided fine needle aspiration in the diagnosis and treatment of cystic lesions of the pancreas. Pancreas 2002;25:222-228.PubMedGoogle Scholar
  80. 80.
    Hittmair A, Pernthaler H, Totsch M, et al. Preoperative fine needle aspiration cytology of a microcystic adenoma of the pancreas. Acta Cytol 1991;35:546-548.PubMedGoogle Scholar
  81. 81.
    Hoang MP, Hruban RH, Albores-Saavedra J. Clear cell endocrine pancreatic tumor mimicking renal cell carcinoma: a distinctive neoplasm of von Hippel-Lindau disease. Am J Surg Pathol 2001;25:602-609.PubMedGoogle Scholar
  82. 82.
    Hruban RH, Takaori K, Klimstra DS, et al. An illustrated consensus on the classification of pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasms. Am J Surg Pathol 2004;28:977-987.PubMedGoogle Scholar
  83. 83.
    Huh JR, Chi JG, Jung KC, et al. Macrocystic serous cystadenoma of pancreas – a case report. J Korean Med Sci 1994;9:78.PubMedGoogle Scholar
  84. 84.
    Hysell C, Belsley N, Deshpande V. EUS guided fine needle aspiration biopsies of solid ductal adenocarcinomas of the pancreas: a criticallookattheatypicalandsuspiciouscategories.Cancer(Cancer Cytopathol) Suppl 2007;111:351-352.Google Scholar
  85. 85.
    Iacono C, Serio G, Fugazzola C, et al. Cystic islet cell tumors of the pancreas. A clinico-pathological report of two nonfunctioning cases and review of the literature. Int J Pancreatol 1992;11:199-208.PubMedGoogle Scholar
  86. 86.
    Itani KM, Taylor TV, Green LK. Needle biopsy for suspicious lesions of the head of the pancreas: pit falls and implications for therapy. J Gastrointest Surg 1997;1:337-341.PubMedGoogle Scholar
  87. 87.
    Jani N, Dewitt J, Eloubeidi M, et al. Endoscopic ultrasound-guided fine-needle aspiration for diagnosis of solid pseudopapillary tumors of the pancreas: a multicenter experience. Endoscopy 2008;40:200-203.PubMedGoogle Scholar
  88. 88.
    Jhala D, Grizzle WE, Jhala N. Clear cells with cytoplasmic vacuolization mimicking macrophages in pancreatic adenocarcinoma in fine needle aspirates obtained by EUS-FNA: a diagnostic caveat. Cancer(Cancer Cytopathol) Suppl 2007;111:416.Google Scholar
  89. 89.
    Jhala N, Jhala D, Vickers SM, et al. Biomarkers in diagnosis of pancreatic carcinoma in fine-needle aspirates. A translational research application. Am J Clin Pathol 2006;126:572-579.PubMedGoogle Scholar
  90. 90.
    Johansson B, Bardi G, Heim S, et al. Nonrandom chromosomal rearrangements in pancreatic carcinoma. Cancer 1992;69:1674-1681.PubMedGoogle Scholar
  91. 91.
    Johnson DE, Pendurthi TK, Balshem AM, et al. Implications of fine-needle aspiration in patients with resectable pancreatic cancer. Am Surg 1997;63:675-679.PubMedGoogle Scholar
  92. 92.
    Kameya S, Kuno N, Kasugai T. The diagnosis of pancreatic cancer by pancreatic juice cytology. Acta Cytol 1981;25:354-360.PubMedGoogle Scholar
  93. 93.
    Kanai N, Nagaki S, Tanaka T. Clear cell carcinoma of the pancreas. Acta Pathol Jpn 1987;37:1521-1526.PubMedGoogle Scholar
  94. 94.
    Kardon DE, Thompson LD, Przygodzki RM, Heffess CS. Adenosquamous carcinoma of the pancreas: a clinicopathologic series of 25 cases. Mod Pathol 2001;14:443-451.PubMedGoogle Scholar
  95. 95.
    Khadaroo R, Knetman N, Joy S, Nguyen GK. Macrocystic serous adenoma of the pancreas. Pathol Res Pract 2002;198:485-491.PubMedGoogle Scholar
  96. 96.
    Khurana A, Rekhi B, Kane SV, et al. Pancreatic tuberculosis masquerading as pancreatic carcinoma in two cases: role of fine needle aspiration cytology in diagnosis. Cytopathology 2007;18:380-383.PubMedGoogle Scholar
  97. 97.
    Kim K, Booth R, Myles J. Transcutaneous fine-needle aspiration biopsy of pancreatic cancer. Int J Pancreatol 1990;7:61-69.PubMedGoogle Scholar
  98. 98.
    Kipp BR, Stadheim LM, Halling SA, et al. A comparison of routine cytology and fluorescence in situ hybridization for the detection of malignant bile duct strictures. Am J Gastroenterol 2004;99:1675-1681PubMedGoogle Scholar
  99. 99.
    Klöppel G, Heitz PU. Pancreatic endocrine tumors. Pathol Res Pract 1988;183:155-168.PubMedGoogle Scholar
  100. 100.
    Klöppel G, Lüttges J. The pathology of ductal-type pancreatic carcinomas and pancreatic intraepithelial neoplasia: insights for clinicians. Curr Gastroenterol Rep 2004;6:111-118.PubMedGoogle Scholar
  101. 101.
    Klöppel G, Hruban RH, Longnecker DS. Ductal adenocarcinoma of the pancreas, in: Hamilton SR, Aaltonen LA (Eds.): World Health Organization Classification of Tumours. Pathology and Genetics of tumours of the digestive system. IARC Press:Lyon 2000Google Scholar
  102. 102.
    Krishnamurthy S, Katz RL, Shumate A, et al. DNA image analysis combined with routine cytology improves diagnostic sensitivity of common bile duct brushing. Cancer 2001;93:229-235.PubMedGoogle Scholar
  103. 103.
    Labate AM, Klimstra DL, Zakowski MF. Comparative cytologic features of pancreatic acinar cell carcinoma and islet cell tumor. Diagn Cytopathol 1997;16:112-116.PubMedGoogle Scholar
  104. 104.
    Lack EE. Pathology of the pancreas, gallbladder, extrahepatic biliary tract, and ampullary region. Oxford University Press, Inc. 2003.Google Scholar
  105. 105.
    Lal A, Bourtsos EP, DeFrias DV, et al. Microcystic adenoma of the pancreas: clinical, radiologic, and cytologic features. Cancer 2004;102:288-294.PubMedGoogle Scholar
  106. 106.
    Layfield LJ, Bentz J. Giant-cell containing neoplasms of the pancreas: an aspiration cytology study. Diagn Cytopathol 2008;36:238-244.PubMedGoogle Scholar
  107. 107.
    Layfield LJ, Cramer H. Fine-needle aspiration cytology of intraductal papillary-mucinous tumors: a retrospective analysis. Diagn Cytopathol 2005;32:16-20.PubMedGoogle Scholar
  108. 108.
    Layfield LJ, Cramer H, Madden J, et al. Atypical squamous epithelium in cytologic specimens from the pancreas: cytological differential diagnosis and clinical implications. Diagn Cytopathol 2001;25:38-42.PubMedGoogle Scholar
  109. 109.
    Lee CS, Charlton IG, Williams RA, et al. Malignant potential of aneuploid pancreatic endocrine tumors. J Pathol 1993;169:451-456.PubMedGoogle Scholar
  110. 110.
    Levy MJ, Baron TH, Clayton AC, et al. Prospective evaluation of advanced molecular markers and imaging techniques in patients with indeterminate bile duct strictures. Am J Gastroenterol 2008;103:1263-1273.PubMedGoogle Scholar
  111. 111.
    Levy MJ, Wiersema MJ, Chari ST. Chronic pancreatitis: focal pancreatitis or cancer? Is there a role for FNA/biopsy? Autoimmune pancreatitis. Endoscopy 2006;38 Suppl 1:S30-35.PubMedGoogle Scholar
  112. 112.
    Lewandrowski KB, Southern JF, Pins MR, et al. Cyst fluid in the differential diagnosis of pancreatic cysts. A comparison of pseudocysts, serous cystadenomas, mucinous cystic neoplasms, and mucinous cystadenocarcinoma. Ann Surg 1993;217:41-47.PubMedGoogle Scholar
  113. 113.
    Lin F, Staerkel G. Cytologic criteria for well differentiated adenocarcinoma of the pancreas in fine-needle aspiration biopsy specimens. Cancer 2003;99:44-50.PubMedGoogle Scholar
  114. 114.
    Lin H, Li SD, Hu XG, Li ZS. Primary pancreatic lymphoma: report of six cases. World J Gastroenterol 2006;12:5064-5067.PubMedGoogle Scholar
  115. 115.
    Lindberg B, Enochsson L, Tribukait B, et al. Diagnostic and prognostic implications of DNA ploidy and S-phase evaluation in the assessment of malignancy in biliary strictures. Endoscopy 2006;38:561-565.PubMedGoogle Scholar
  116. 116.
    Linder JD, Geenen JE, Catalano MF. Cyst fluid analysis obtained by EUS-guided FNA in the evaluation of discrete cystic neoplasms of the pancreas: a prospective single-center experience. Gastrointest Endoscop 2006;64:697-702.Google Scholar
  117. 117.
    Liu F, Li ZS, Xu GM, et al. Detection of K-ras gene mutation at codon 12 by pancreatic duct brushing for pancreatic cancer. Hepatobiliary Pancreat Dis Int 2003;2:313-317.PubMedGoogle Scholar
  118. 118.
    Logrono R, Vyas SH, Molina CP, Waxman I. Microcystic adenoma of the pancreas: cytologic appearance on percutaneous and endoscopic ultrasound-guided fine-needle aspiration: report of a case. Diagn Cytopathol 1999;20:298-301.PubMedGoogle Scholar
  119. 119.
    Logrono R, Wong JY. Reporting the presence of significant epithelial atypia in pancreaticobiliary brush cytology specimens lacking evidence of obvious carcinoma: impact on performance measures. Acta Cytol 2004;48:613-621.PubMedGoogle Scholar
  120. 120.
    Longnecker DS, Adler G. Intraductal papillary-mucinous neoplasms of the pancreas. in: Hamilton SR, Aaltonen LA. (Eds.): World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of the Digestive Sytem. IARC Press:Lyon 2000.Google Scholar
  121. 121.
    Loya AC, Prayaga AK, Sundaram C, et al. Cytologic diagnosis of pancreatic tuberculosis in immunocompetent and immunocompromised patients: a report of 2 cases. Acta Cytol 2005;49:97-100.PubMedGoogle Scholar
  122. 122.
    Loya AC, Ratnakar KS, Shastry RA. Combined osteoclastic giant cell and pleomorphic giant cell tumor of the pancreas: a rarity. An immunohistochemical analysis and review of the literature. JOP 2004;5:220-224.PubMedGoogle Scholar
  123. 123.
    Lüttges J, Vogel I, Menke M, et al. Clear cell carcinoma of the pancreas: an adenocarcinoma with ductal phenotype. Histopathology 1998;32:444-448.PubMedGoogle Scholar
  124. 124.
    Mackie CR, Cooper MJ, Lewis MH, Moossa AR. Non-operative differentiation between pancreatic cancer and chronic pancreatitis. Ann Surg 1979;189:480-487.PubMedGoogle Scholar
  125. 125.
    Maitra A, Fukushima N, Takaori K, Hruban RH. Precursors to invasive pancreatic cancer. Adv Anat Pathol 2005;12:81-91.PubMedGoogle Scholar
  126. 126.
    Malberger E, Lemberg S, Edoute Y. Intraoperative fine needle aspiration cytology of pancreatic lesions. J Surg Oncol 1991;46:241-245.PubMedGoogle Scholar
  127. 127.
    Micames C, Jowell PS, White Ch BR, et al. Lower frequency of peritoneal carcinomatosis in patients with pancreatic cancer diagnosed by EUS-guided FNA vs. percutaneous FNA. Gastrointest Endosc 2003;58:690-695.PubMedGoogle Scholar
  128. 128.
    Michaels PJ, Brachtel EF, Bounds BC, et al. Intraductal papillary mucinous neoplasm of the pancreas: cytologic features predict histologic grade. Cancer 2006;108:163-173.PubMedGoogle Scholar
  129. 129.
    Mitchell ML, Carney CN. Cytologic criteria for the diagnosis of pancreatic carcinoma. Am J Clin Pathol 1985;83:171-176.PubMedGoogle Scholar
  130. 130.
    Morena Luna LE, Kipp B, Halling KC, et al. Advanced cytologic techniques for the detection of malignant pancreatobiliary strictures. Gastroenterology 2006;131:1064-1072.Google Scholar
  131. 131.
    Morinaga S, Tsumuraya M, Nakajima T, et al. Ciliated-cell adenocarcinoma of the pancreas. Acta Pathol Jpn 1986;36:1905-1910.PubMedGoogle Scholar
  132. 132.
    Motojima K, Furui J, Terada M, et al. Small cell carcinoma of the pancreas and biliary tract. J Surg Oncol 1990;45:164-168.PubMedGoogle Scholar
  133. 133.
    Müller-Hermelink HK, Chott A, Gascoyne RD, Wotherspoon A. Lymphoma of the pancreas. in: Hamilton SR, Aaltonen LA (Eds.): World Health Organization Classification of Tumours. Pathology and Genetics of tumours of the digestive system. IARC Press:Lyon 2000.Google Scholar
  134. 134.
    Murakami Y, Yokoyama T, Yokoyama Y, et al. Adenosquamous carcinoma of the pancreas: preoperative diagnosis and molecular alterations. J Gastroenterol 2003;38:1171-1175.PubMedGoogle Scholar
  135. 135.
    Nai GA, Amico E, Gimenez VR, Guilmar M. Osteoclast-like giant cell tumor of the pancreas associated with mucus-secreting adenocarcinoma. Case report and discussion of the histogenesis. Pancreatology 2005;5:279-284.PubMedGoogle Scholar
  136. 136.
    Nakaizumi A, Tatsuta M, Uehara H, et al. Cytologic examination of pure pancreatic juice in the diagnosis of pancreatic carcinoma. The endoscopic retrograde intraductal catheter aspiration cytology technique. Cancer 1992;70:2610-2614.PubMedGoogle Scholar
  137. 137.
    Nakaizumi A, Tatsuta M, Uehara H, et al. Effectiveness of the cytologic examination of pure pancreatic juice in the diagnosis of early neoplasia of the pancreas. Cancer 1995;76:750-757.PubMedGoogle Scholar
  138. 138.
    Nakaizumi A, Tatsuta M, Uehara H, et al. Usefulness of simple endoscopic aspiration cytology of pancreatic juice for diagnosis of early pancreatic neoplasm. A prospective study. Dig Dis Sci 1997;42:1796-1803.PubMedGoogle Scholar
  139. 139.
    Nakaizumi A, Uehara H, Takenaka A, et al. Diagnosis of pancreatic cancer by cytology and measurement of oncogene and tumor markers in pure pancreatic juice aspirated by endoscopy. Hepatogastroenterology 1999;46:31-37.PubMedGoogle Scholar
  140. 140.
    Nguyen GK, Vogelsang PJ. Microcystic adenoma of the pancreas. A report of two cases with fine needle aspiration cytology and differential diagnosis. Acta Cytol 1993;37:908-912.PubMedGoogle Scholar
  141. 141.
    Nicolas MM, Talamonti M, Rao MS. Mesothelial cyst of the pancreas. Ann Diagn Pathol 2006;10:371-373.PubMedGoogle Scholar
  142. 142.
    Nunobe S, Fukushima N, Yachida S, et al. Clear cell endocrine tumor of the pancreas which is not associated with von Hippel-Lindau disease: report of a case. Surg Today 2003;33:470-474.PubMedGoogle Scholar
  143. 143.
    Oku T, Maeda M, Wada Y, et al. Intraductal oncocytic papillary neoplasm having clinical characteristics of mucinous cystic neoplasm and a benign histology. JOP 2007;8:206-213.PubMedGoogle Scholar
  144. 144.
    Ott C, Heinmöller E, Gaumann A, et al. Intraepithelial neoplasms (PanIN) and intraductal papillary-mucinous neoplasms (IPMN) of the pancreas as precursor lesions of pancreatic carcinoma. Med Klin (Munich) 2007;102:127-135.Google Scholar
  145. 145.
    O’Toole D, Palazzo L, Arotcarena R, et al. Assessment of complications of EUS-guided fine-needle aspiration. Gastrointest Endosc 2001;53:470-474.PubMedGoogle Scholar
  146. 146.
    Pacchioni D, Papotti M, Macri L, et al. Pancreatic oncocytic endocrine tumors. Cytologic features of two cases. Acta Cytol 1996;40:742-746.PubMedGoogle Scholar
  147. 147.
    Peng HQ, Greenwald BD, Tavora FR, et al. Evaluation of performance of EUS-FNA in preoperative lymph node staging of cancers of esophagus, lung, and pancreas. Diagn Cytopathol 2008;36:290-296.PubMedGoogle Scholar
  148. 148.
    Pitman MB, Deshpande V. Endoscopic ultrasound-guided fine needle aspiration cytology of the pancreas: a morphological and multimodal approach to the diagnosis of solid and cystic mass lesions. Cytopathology 2007;18:331-347.PubMedGoogle Scholar
  149. 149.
    Pitman MB, Faquin WC. The fine-needle aspiration biopsy cytology of pancreatoblastoma. Diagn Cytopathol 2004;31:402-406.PubMedGoogle Scholar
  150. 150.
    Pugliese V, Pujic N, Saccomanno S, et al. Pancreatic intraductal sampling during ERCP in patients with chronic pancreatitis and pancreatic cancer: cytologic studies and k-ras-2 codon 12 molecular analysis in 47 cases. Gastrointest Endosc 2001;54:595-599.PubMedGoogle Scholar
  151. 151.
    Rahemtullah A, Misdraji J, Pitman MB. Adenosquamous carcinoma of the pancreas: cytologic features in 14 cases. Cancer 2003;99:372-378.PubMedGoogle Scholar
  152. 152.
    Ramirez-Luna MA, Zepeda-Gomez S, Chavez-Tapia NC, Tellez-Avila FI. Diagnostic yield and therapeutic impact of fine-needle aspiration biopsies guided by endoscopic ultrasound in pancreatic lesions. Rev Invest Clin 2008;60:11-14.PubMedGoogle Scholar
  153. 153.
    Raut CP, Fernandez-Del Castillo C. Giant lipoma of the pancreas: Case report and review of lipomatous lesions of the pancreas. Pancreas 2003;26:97-99.PubMedGoogle Scholar
  154. 154.
    Ray B, New NE, Wedgwood KR. Clear cell carcinoma of exocrine pancreas: a rare tumor with an unusual presentation. Pancreas 2005;30:184-185.PubMedGoogle Scholar
  155. 155.
    Ray S, Lu Z, Rajendiran S. Clear cell ductal adenocarcinoma of pancreas: a case report and review of the literature. Arch Pathol Lab Med 2004;128:693-696.PubMedGoogle Scholar
  156. 156.
    Reyes CV, Wang T. Undifferentiated small cell carcinoma of the pancreas: a report of five cases. Cancer 1981;47:2500-2502.PubMedGoogle Scholar
  157. 157.
    Robins DB, Katz RL, Evans DB, et al. Fine needle aspiration of the pancreas. In quest of accuracy. Acta Cytol 1995;39:1-10.PubMedGoogle Scholar
  158. 158.
    Rumalla A, Baron TH, Leontovich O, et al. Improved diagnostic yield of endoscopic biliary brush cytology by digital image analysis. Mayo Clin Proc 2001;76:29-33.PubMedGoogle Scholar
  159. 159.
    Ryan ME, Baldauf MC. Comparison of flow cytometry for DNA content and brush cytology for detection of malignancy in pancreaticobiliary strictures. Gastrointest Endosc 1994;40:133-139.PubMedGoogle Scholar
  160. 160.
    Ryozawa S, Kitoh H, Gondo T, et al. Usefulness of endoscopic ultrasound-guided fine-needle aspiration biopsy for the diagnosis of pancreatic cancer. J Gastroenterol 2005;40:907-911.PubMedGoogle Scholar
  161. 161.
    Sadoul JL, Saint-Paul MC, Hoffman P, et al. Malignant pancreatic oncocytoma. An unusual cause of organic hypoglycemia. J Endocrinol Invest 1992;15:211-217.PubMedGoogle Scholar
  162. 162.
    Saez A, Catala I, Brossa R, et al. Intraoperative fine needle aspiration cytology of pancreatic lesions. A study of 90 cases. Acta Cytol 1995;39:485-488.PubMedGoogle Scholar
  163. 163.
    Sai JK, Suyama M, Kubokawa Y, Watanabe S. Pancreatic duct lavage cytology for the diagnosis of branch duct-type intraductal papillary mucinous neoplasm of the pancreas. Pancreas 2008;36:216-217PubMedGoogle Scholar
  164. 164.
    Salla C, Chatzipantelis P, Konstantinou P, et al. Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of solid pseudopapillary tumor of the pancreas: a case report and literature review. World J Gastroenterol 2007;13:5158-5163.PubMedGoogle Scholar
  165. 165.
    Salla C, Chatzipantelis P, Konstantinou P, et al. Endoscopic ultrasound-guided fine-needle aspiration cytology in the diagnosis of intraductal papillary mucinous neoplasms of the pancreas. A study of 8 cases. JOP 2007;8:715-724.PubMedGoogle Scholar
  166. 166.
    Samuel LH, Frierson HF Jr. Fine needle aspiration cytology of acinar cell carcinoma of the pancreas: a report of two cases. Acta Cytol 1996;40:585-591.PubMedGoogle Scholar
  167. 167.
    Sand JA, Hyoty MK, Mattila J, et al. Clinical assessment compared with cyst fluid analysis in the differential diagnosis of cystic lesions in the pancreas. Surgery 1996;119:275-280.PubMedGoogle Scholar
  168. 168.
    Sariya D, Kluskens L, Assad L, et al. Diagnostic role of fineneedle aspiration of pancreatic allograft to detect rejection. Diagn Cytopathol 2002;27:266-270.PubMedGoogle Scholar
  169. 169.
    Schreiner AM, Mansoor A, Faigel DO, Morgan TK. Intrapancreatic accessory spleen: mimic of pancreatic endocrine tumor diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy. Diagn Cytopathol 2008;36:262-265.PubMedGoogle Scholar
  170. 170.
    Shabaik A. Endoscopic ultrasound-guided fine needle aspiration cytology of intraductal papillary mucinous tumor of the pancreas. A case report. Acta Cytol 2003;47:657-662.PubMedGoogle Scholar
  171. 171.
    Sheehan MM, Fraser A, Ravindran R, McAteer D. Bile duct brushings cytology – improving sensitivity of diagnosis using the ThinPrep technique: a review of 113 cases. Cytopathology 2007;18:225-233.PubMedGoogle Scholar
  172. 172.
    Siddiqui MT, Gokasian ST, Saboorian MH, et al. Comparison of ThinPrep and conventional smears in detecting carcinoma in bile duct brushings. Cancer 2003;99:205-210.PubMedGoogle Scholar
  173. 173.
    Silverman JF, Dabbs DJ, Finley JL, Geisinger KR. Fine needle aspiration biopsy of pleomorphic (giant cell) carcinoma of the pancreas. Cytologic, immunocytochemical, and ultrastructural findings. Am J Clin Pathol 1988;89:714-720.PubMedGoogle Scholar
  174. 174.
    Silverman JF, Finley JL, MacDonald KG Jr. Fine-needle aspiration cytology of osteoclastic giant-cell tumor of the pancreas. Diagn Cytopathol 1990;6:336-340.PubMedGoogle Scholar
  175. 175.
    Silverman JF, Holbrook CT, Pories WJ, et al. Fine needle aspiration cytology of pancreatoblastoma with immunocytochemical and ultrastructural studies. Acta Cytol 1990;34:632-640.PubMedGoogle Scholar
  176. 176.
    Smit W, Mathy JP, Donaldson E. Pancreatic cytology and adenosquamous carcinoma of the pancreas. Pathology 1993;25:420-422.PubMedGoogle Scholar
  177. 177.
    Smithies A, Hatfield ARW, Brown BE. The cytodiagnostic aspects of pure pancreatic juice obtained at the time of endoscopic retrograde cholangio-pancreatography (E.R.C.P.) Acta Cytol 1977;21:191-195.PubMedGoogle Scholar
  178. 178.
    Solcia E, Capella C, Klöppel G. Tumors of the endocrine pancreas. in E Socia, C Capella, G Klöppel (eds), Atlas of Tumor Pathology: Tumors of the Pancreas (3rd ed). Washington, DC: Armed Forces Institute of Pathology, 1997.Google Scholar
  179. 179.
    Solé M, Iglesias C, Fernandez-Esparrach G, et al. Fine-needle aspiration cytology of intraductal papillary mucinous tumors of the pancreas. Cancer 2005;105:298-303.PubMedGoogle Scholar
  180. 180.
    Solmi L, Gandolfi L, Muratori R, et al. Echo-guided fine-needle biopsy of pancreatic masses. Am J Gastroenterol 1987;82:744-748.PubMedGoogle Scholar
  181. 181.
    Sperti C, Pasquali C, Costantino V, et al. Solitary true cyst of the pancreas in adults. Report of three cases and review of the literature. Int J Pancreatol 1995;18:161-167.PubMedGoogle Scholar
  182. 182.
    Sperti C, Pasquali C, Di Prima F, et al. Percutaneous CT-guided fine needle aspiration cytology in the differential diagnosis of pancreatic lesions. Ital J Gastroenterol 1994;26:126-131.PubMedGoogle Scholar
  183. 183.
    Stelow EB, Bardales RH, Shami VM, et al. Cytology of pancreatic acinar cell carcinoma. Diagn Cytopathol 2006;34:367-372.PubMedGoogle Scholar
  184. 184.
    Stelow EB, Stanley MW, Bardales RH, et al. Intraductal papillary – mucinous neoplasm of the pancreas. The findings and limitations of cytologic samples obtained by endoscopic ultrasoundguided fine-needle aspiration. Am J Clin Pathol 2003;120:398-404.PubMedGoogle Scholar
  185. 185.
    Stewart CJ, Mills PR, Carter R, et al. Brush cytology in the assessment of pancreatico-biliary strictures: a review of 406 cases. J Clin Pathol 2001;54:449-455.PubMedGoogle Scholar
  186. 186.
    Stipa F, Arganini M, Bibbo M, et al. Nuclear DNA analysis of insulinomas and gastrinomas. Surgery 1987;102:988-998.PubMedGoogle Scholar
  187. 187.
    Tanno S, Obara T, Izawa T, et al. Solitary true cyst of the pancreas in two adults: analysis of cyst fluid and review of the literature. Am J Gastroenterol 1998;93:1972-1975.PubMedGoogle Scholar
  188. 188.
    Tascilar M, Sturm PD, Caspers E, et al. Diagnostic p53 immunostaining of endobiliary brush cytology: preoperative cytology compared with the surgical specimen. Cancer 1999;87:306-311.PubMedGoogle Scholar
  189. 189.
    Teplick SK, Haskin PH, Kline TS, et al. Percutaneous pancreaticobiliary biopsies in 173 patients using primarily ultrasound or fluoroscopic guidance. Cardiovasc Intervent Radiol 1988;11:26-28.PubMedGoogle Scholar
  190. 190.
    Terada T, Kawaguchi M, Furukawa K, et al. Minute mixed ductalendocrine carcinoma of the pancreas with predominant intraductal growth. Pathol Int 2002;52:740-746.PubMedGoogle Scholar
  191. 191.
    Terada T, Matsunaga Y, Maeta H, et al. Mixed ductal-endocrine carcinoma of the pancreas presenting as gastrinoma with Zollinger-Ellison syndrome. An autopsy case with a 24-year survival period. Virchows Arch 1999;435:606-611.PubMedGoogle Scholar
  192. 192.
    Tikkakoski T, Siniluoto T, Päivänsalo M, et al. Diagnostic accuracy of ultrasound-guided fine-needle-aspiration pancreatic biopsy. Rofo 1992;156:178-181.PubMedGoogle Scholar
  193. 193.
    Tomita T, Bhatia P, Gourley W. Mucin producing islet cell adenoma. Hum Pathol 1981;12:850-853.PubMedGoogle Scholar
  194. 194.
    Truong LD, Stewart MG; Hao H, et al. A comprehensive characterization of lymphoepithelial cyst associated with the pancreas. Am J Surg 1995;170:27.PubMedGoogle Scholar
  195. 195.
    Tsuchiya Y, Suzuki S, Sakaguchi T, et al. Lymphoepithelial cyst of the pancreas: report of a case. Surg Today 2000;30:856-860.PubMedGoogle Scholar
  196. 196.
    Tumors of the exocrine pancreas. in: Hamilton SR, Aaltonen LA (Eds.): World Health Organization Classification of Tumours. Pathology and Genetics of tumours of the digestive system. IARC Press:Lyon 2000Google Scholar
  197. 197.
    Tylen U, Arnesjö B, Lindberg LG, et al. Percutaneous biopsy of carcinoma of the pancreas guided by angiography. Surgery, Gynec Obstet 1976;142:737-739.Google Scholar
  198. 198.
    Varadarajulu S, Tamhane A, Eloubeidi MA. Yield of EUS-guided FNA of pancreatic masses in the presence or the absence of chronic pancreatitis. Gastrointest Endoscop 2005;62:728-736.Google Scholar
  199. 199.
    Vermeulen BJ, Widgren S, Gur V, et al. Dermoid cyst of the pancreas. Case report and review of the literature. Gastroenterol Clin Biol 1990;14:1023-1025.PubMedGoogle Scholar
  200. 200.
    Volante M, La Rosa S, Castellano I, et al. Clinico-pathological features of a series of 11 oncocytic endocrine tumours of the pancreas. Virchows Arch 2006;448:545-551.PubMedGoogle Scholar
  201. 201.
    Volmar KE, Vollmer RT, Routbort MJ, Creager AJ. Pancreatic and bile duct brushing cytology in 1000 cases: review of findings and comparison of preparation methods. Cancer 2006;108:231-238.PubMedGoogle Scholar
  202. 202.
    Wakatsuki T, Irisawa A, Bhutani MS, et al. Comparative study of diagnostic value of cytologic sampling by endoscopic ultrasonography-guided fine-needle aspiration and that by endoscopic retrograde pancreatography for the management of pancreatic mass without biliary stricture. J Gastroenterol Hepatol 2005;20:1707-1711.PubMedGoogle Scholar
  203. 203.
    Weissmann D, Lewandrowski K, Godine J, et al. Pancreatic cystic islet-cell tumors. Clinical and pathologic features in two cases with cystic fluid analysis. Int J Pancreatol 1994;15:75-79.PubMedGoogle Scholar
  204. 204.
    Wilson JL, Kalade A, Prasad S, et al. Diagnosis of solid pancreatic masses by endoscopic ultrasound-guided fine-needle aspiration. Intern Med J 2009;39:32-37.PubMedGoogle Scholar
  205. 205.
    Wittmann J, Kocjan G, Sgouros SN, et al. Endoscopic ultrasoundguided tissue sampling by combined fine needle aspiration and trucut needle biopsy: a prospective study. Cytopathology 2006;17:27-33.PubMedGoogle Scholar
  206. 206.
    Xing GS, Geng JC, Han XW, et al. Endobiliary brush cytology during percutaneous transhepatic cholangiodrainage in patients with obstructive jaundice. Hepatobiliary Pancreat Dis Int 2005;4:98-103.PubMedGoogle Scholar
  207. 207.
    Yamaguchi T, Shirai Y, Ishihara T. Pancreatic juice cytology in the diagnosis of intraductal papillary mucinous neoplasm of the pancreas: significance of sampling by peroral pancreatoscopy. Cancer 2005;104:2830-2836.PubMedGoogle Scholar
  208. 208.
    Yan BM, Pai RK, Van Dam J. Diagnosis of pancreatic gastrointestinal stromal tumor by EUS guided FNA. JOP 2008;9:192-196.PubMedGoogle Scholar
  209. 209.
    Yantiss RK, Cosar E, Fischer AH. Use of IMP3 in identification of carcinoma in fine needle aspiration of pancreas. Acta Cytol 2008;52:133-138.PubMedGoogle Scholar
  210. 210.
    Ylagan LR, Edmundowicz S, Kasal K, et al. Endoscopic ultrasound guided fine-needle aspiration cytology of pancreatic carcinoma: a 3-year experience and review of the literature. Cancer 2002;96:362-369.PubMedGoogle Scholar
  211. 211.
    Zamboni G, Klöppel G, Hruban RH et al. Mucinous cystic neoplasms of the pancreas. in: Hamilton SR, Aaltonen LA. (Eds.): World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of the Digestive Sytem. IARC Press:Lyon 2000Google Scholar
  212. 212.
    Zhang S, Luzadder R, Ramos MC, et al. Using EUS-FNA in the evaluation of pancreatic cystic lesions: five years experience from Northwestern University, Feinberg School of Medicine. Cancer(Cancer Cytopathol) Suppl 2007;111:415-416.Google Scholar
  213. 213.
    Zhu LC, Sidhu GS, Cassai ND, Yang GC. Fine-needle aspiration cytology of pancreatoblastoma in a young woman: report of a case and review of the literature. Diagn Cytopathol 2005;33:258-262.PubMedGoogle Scholar

Further Reading (Sect. 10.2)

  1. 1.
    Akosa AB, Barker F, Desa L, et al. Cytologic diagnosis in the management of gallbladder carcinoma. Acta Cytol 1995;39:494-498.PubMedGoogle Scholar
  2. 2.
    Albores-Saavedra J, Henson DE, Klimstra D. Tumors of the Gallbladder and Extrahepatic Bile Ducts. Atlas of Tumor Pathology. Third series. AFIP: Washington D.C. 1999.Google Scholar
  3. 3.
    Albores-Saavedra J, Scoazec JC, Wittekind C, et al. Carcinoma of the gallbladder and extrahepatic bile ducts. In:Hamilton SR, Aaltonen LA (Eds.): World Health classification of tumors. Pathology and Genetics of tumours of the digestive system. IARC Press:Lyon 2000.Google Scholar
  4. 4.
    Athanassiadou P, Grapsa D. Value of endoscopic retrograde cholangiopancreatography-guided brushings in preoperative assessment of pancreaticobiliary strictures. What’s new? Acta Cytol 2008;52:24-34.PubMedGoogle Scholar
  5. 5.
    Backman H. Metastases of malignant melanoma in the gastrointestinal tract. Geriatrics 1969;24:112-120.PubMedGoogle Scholar
  6. 6.
    Bardales RH, Stanley MW, Simpson DD, et al. Diagnostic value of brush cytology in the diagnosis of duodenal, biliary, and ampullary neoplasms. Am J Clin Pathol 1998;109:540-548.PubMedGoogle Scholar
  7. 7.
    Baron TH, Harewood GC, Rumalla A, et al. A prospective comparison of digital image analysis and routine cytology for the identification of malignancy in biliary tract strictures. Clin Gastroenterol Hepatol 2004;2:214-219.PubMedGoogle Scholar
  8. 8.
    Barr Fritcher E, Kipp B, Oberg T, et al. Advanced cytologic techniques for the detection of metastatic malignancy in pancreatobiliary tract strictures. Cancer(Cancer Cytopathol) Suppl. 2007;111:415.Google Scholar
  9. 9.
    Bergquist A, Lindberg B, Castro J, Tribukait B. Methodologic aspects of evaluating brush samples from biliary strictures by cytology and DNA flow cytometry. Acta Cytol 2004;48:341-347.PubMedGoogle Scholar
  10. 10.
    Bergquist A, Tribukait B, Glaumann H, Broome U. Can DNA cytometry be used for evaluation of malignancy and premalignancy in bile duct strictures in primary sclerosing cholangitis? J Hepatol 2000;33:873-877.PubMedGoogle Scholar
  11. 11.
    Binek J, Lindenmann N, Meyenberger CM, Spieler P, et al. Malignant biliary stenosis: Conventional cytology versus DNA image cytometry. Surg Endosc 2011;25:1808-1813.PubMedGoogle Scholar
  12. 12.
    Binek JS, Meyenberger C, Spieler P, et al. DNA-image-cytometry (ICM-DNA) of brush cytology for the diagnosis of malignant biliary tumors. Gastroenterology, Suppl 1 2001;120:A-573.Google Scholar
  13. 13.
    Boberg KM, Jebsen P, Clausen OP, et al. Diagnostic benefit of biliary brush cytology in cholangiocarcinoma in primary sclerosing cholangitis. J Hepatol 2006;45:568-574.PubMedGoogle Scholar
  14. 14.
    Byrne MF, Gerke H, Mitchell RM, et al. Yield of endoscopic ultrasound-guided fine-needle aspiration of bile duct lesions. Endoscopy 2004;36:715-719.PubMedGoogle Scholar
  15. 15.
    Case records of the Massachusetts General Hospital. Case 3-2002. 2002;346:271-276.Google Scholar
  16. 16.
    Chew TS, Hopper AD, Sanders DS. Is there a role for routine biopsy in diagnosing giardiasis in a European population? Scand J Gastroenterol 2008;8:1-5.Google Scholar
  17. 17.
    Cohan RH, Illescas FF, Braun SD, et al. Fine needle aspiration biopsy in malignant obstructive jaundice. Gastrointest Radiol 1986;11:145-150.PubMedGoogle Scholar
  18. 18.
    Cohen MB, Wittchow RJ, Johlin FC, et al. Brush cytology of the extrahepatic biliary tract: comparison of cytologic features of adenocarcinoma and benign biliary strictures. Mod Pathol 1995;8:498-502.PubMedGoogle Scholar
  19. 19.
    de Bellis M, Sherman S, Fogel EL, et al. Tissue sampling at ERCP in suspected malignant biliary strictures (Part 1). Gastrointest Endosc 2002;56:552-561.PubMedGoogle Scholar
  20. 20.
    Defrain C, Chang CY, Srikureja W, et al. Cytologic features and diagnostic pitfalls of primary ampullary tumors by endoscopic ultrasound-guided fine-needle aspiration biopsy. Cancer 2005;105:289-297.PubMedGoogle Scholar
  21. 21.
    DeWitt J, Misra VL, Leblanc JK, et al. EUS-guided FNA of proximal biliary strictures after negative ERCP brush cytology results. Gastrointest Endosc 2006;64:325-333.PubMedGoogle Scholar
  22. 22.
    Elek G, Gyökeres T, Schäfer E, et al. Early diagnosis of pancreatobiliary duct malignancies by brush cytology and biopsy. Pathol Oncol Res 2005;11:145-155.PubMedGoogle Scholar
  23. 23.
    Eloubeidi MA, Chen VK, Jhala NC, et al. Endoscopic ultrasoundguided fine-needle aspiration biopsy of suspected cholangiocarcinoma. Clin Gastroenterol Hepatol 2004;2:209-213.PubMedGoogle Scholar
  24. 24.
    Fritscher-Ravens A, Broering DC, Knoepfel WT, et al. EUS-guided fine-needle aspiration of suspected hilar cholangiocarcinoma in potentially operable patients with negative brush cytology. Am J Gastroenterol 2004;99:45-51.PubMedGoogle Scholar
  25. 25.
    Glasbrenner B, Ardan M, Boeck W, et al. Prospective evaluation of brush cytology of biliary strictures during endoscopic retrograde cholangiopancreatography. Endoscopy 1999;31:712-717.PubMedGoogle Scholar
  26. 26.
    Govil H, Reddy V, Kluskens L, et al. Brush cytology of the biliary tract: retrospective study of 278 cases with histopathologic correlation. Diagn Cytopathol 2002;26:273-277.PubMedGoogle Scholar
  27. 27.
    Harrison PM. Prevention of bile duct cancer in primary sclerosing cholangitis. Ann Oncol 1999;10:208-211.PubMedGoogle Scholar
  28. 28.
    Henson DE, Albores-Saavedra J, Corle D. Carcinoma of the extrahepatic bile ducts. Cancer 1992;70:1498-1501.PubMedGoogle Scholar
  29. 29.
    Hoang MP, Murakata LA, Padilla-Rodriguez AL, et al. Metaplastic lesions of the extrahepatic bile ducts: a morphologic and immunohistochemical study. Mod Pathol 2001;14:1119-1125.PubMedGoogle Scholar
  30. 30.
    Howell DA, Beveridge RP, Bosco J, Jones M. Endoscopic needle aspiration biopsy at ERCP in the diagnosis of biliary strictures. Gastrointest Endosc 1992;38:531-535.PubMedGoogle Scholar
  31. 31.
    Hughes JH, Niemann TH. Adenosquamous carcinoma of the bile duct: cytologic features of brush specimens from two cases. Diagn Cytopathol 1996;15:322-324.PubMedGoogle Scholar
  32. 32.
    Jain KM, Hastings OM, Rickert RR, et al. Granular cell tumor of the common bile duct. Case report and review of literature. Am J Gastroenterol 1979;71:401-407.PubMedGoogle Scholar
  33. 33.
    Ji Y, Zhou J, Wang BS, et al. Intraductal papillary neoplasms of bile duct. A distinct entity like its counterpart in pancreas. Histol Histopathol 2008;23:41-50.PubMedGoogle Scholar
  34. 34.
    Joo YE, Park CH, Lee WS, et al. Primary non-Hodgkin’s lymphoma of the common bile duct presenting as obstructive jaundice. J Gastroenterol 2004;39:692-696.PubMedGoogle Scholar
  35. 35.
    Kipp BR, Stadheim LM, Halling SA, et al. A comparison of routine cytology and fluorescence in situ hybridization for the detection of malignant bile duct strictures. Am J Gastroenterol 2004;99:1675-1681.PubMedGoogle Scholar
  36. 36.
    Klatskin G. Adenocarcinoma of the hepatic duct at its bifurcation within the porta hepatis: an unusual tumor with distinctive clinical and pathological features. Am J Med 1965;38:241-256.PubMedGoogle Scholar
  37. 37.
    Kline TS, Joshi LP, Goldstein F. Preoperative diagnosis of pancreatic malignancy by the cytologic examination of duodenal secretions. Am J Clin Pathol 1978;70:851-854.PubMedGoogle Scholar
  38. 38.
    Krishnamurthy S, Katz RL, Shumate A, et al. DNA image analysis combined with routine cytology improves diagnostic sensitivity of common bile duct brushing. Cancer 2001;93:229-235.PubMedGoogle Scholar
  39. 39.
    Lack EE. Pathology of the extrahepatic biliary tract and ampullary region. in: Pathology of the Pancreas, Gallbladder, Extrahepatic Biliary Tract, and Ampullary Region. Oxford University Press, Inc. 2003.Google Scholar
  40. 40.
    Lal A, Okonkwo A, Schindler S, et al. Role of biliary brush cytology in primary sclerosing cholangitis. Acta Cytol 2004;48:9-12.PubMedGoogle Scholar
  41. 41.
    Layfield LJ, Cramer H. Primary sclerosing cholangitis as a cause of false positive bile duct brushing cytology: report of two cases. Diagn Cytopathol 2005;32:119-124.PubMedGoogle Scholar
  42. 42.
    Layfield LJ, Wax TD, Lee JG, Cotton PB. Accuracy and morphologic aspects of pancreatic and biliary duct brushings. Acta Cytol 1995;39:11-18.PubMedGoogle Scholar
  43. 43.
    Levy MJ, Baron TH, Clayton AC, et al. Prospective evaluation of advanced molecular markers and imaging techniques in patients with indeterminate bile duct strictures. Am J Gastroenterol 2008;103:1263-1273.PubMedGoogle Scholar
  44. 44.
    Levy MJ, Clain JE, Clayton A, et al. Preliminary experience comparing routine cytology results with the composite results of digital image analysis and fluorescence in situ hybridization in patients undergoing EUS-guided FNA: Gastrointest Endosc 2007;66:483-490.PubMedGoogle Scholar
  45. 45.
    Lindberg B, Arnelo U, Bergquist A, et al. Diagnosis of biliary strictures in conjunction with endoscopic retrograde cholangiopancreaticography, with special reference to patients with primary sclerosing cholangitis. Endoscopy 2002;34:909-916.PubMedGoogle Scholar
  46. 46.
    Lindberg B, Enochsson L, Tribukait B, et al. Diagnostic and prognostic implications of DNA ploidy and S-phase evaluation in the assessment of malignancy in biliary strictures. Endoscopy 2006;38:561-565.PubMedGoogle Scholar
  47. 47.
    Logrono R, Kurtycz DF, Molina CP, et al. Analysis of false negative diagnosis on endoscopic brush cytology of biliary and pancreatic duct strictures: the experience at 2 university hospitals. Arch Pathol Lab Med 2000;124:387-392.PubMedGoogle Scholar
  48. 48.
    Mahmoudi N, Enns R, Amar J, et al. Biliary brush cytology: factors associated with positive yields on biliary brush cytology. World J Gastroenterol 2008;14:569-573.PubMedGoogle Scholar
  49. 49.
    Matsubara S, Arizumi T, Togawa O, et al. Endoscopic transpapillary approach to the gallbladder for diagnosing gallbladder cancer. Can J Gastroenterol 2007;21:809-813.PubMedGoogle Scholar
  50. 50.
    Meara RS, Jhala D, Eloubeidi MA, et al. Endoscopic ultrasoundguided FNA biopsy of bile duct and gallbladder: analysis of 53 cases. Cytopathology 2006;17:42-49.PubMedGoogle Scholar
  51. 51.
    Moreno Luna LE, Kipp B, Halling KC, et al. Advanced cytologic techniques for the detection of malignant pancreatobiliary strictures. Gastroenterology 2006;131:1064-1072.PubMedGoogle Scholar
  52. 52.
    Nakeeb A, Pitt HA, Sohn TA, et al. Cholangiocarcinoma: a spectrum of intrahepatic, perihilar and distal tumors. Ann Surg 1996;224:463-475.PubMedGoogle Scholar
  53. 53.
    Nieburgs HE, Dreiling DA, Rubio C, Reisman H. The morphology of cells in duodenal-drainage smears: histologic origin and pathologic significance. Amer J Dig Dis 1962;7:489-505.PubMedGoogle Scholar
  54. 54.
    Okonkwo AM, De Frias DV, Gunn R, et al. Reclassification of “atypical” diagnoses in endoscopic retrograde cholangio-pancreatography-guided biliary brushings. Acta Cytol 2003;47:435-442.PubMedGoogle Scholar
  55. 55.
    Osterheld MC, Andrejevic Blant S, Caron L, et al. Digital image DNA cytometry: a useful tool for the evaluation of malignancy in biliary strictures. Cell Oncol 2005;27:255-260.PubMedGoogle Scholar
  56. 56.
    Ponchon T, Gagnon P, Berger F, et al. Value of endobiliary brush cytology and biopsies for the diagnosis of malignant bile duct stenosis: results of a prospective study. Gastrointest Endoscop 1995;42:565-572.Google Scholar
  57. 57.
    Renshaw AA, Madge R, Jiroutek M, Granter SR. Bile duct brushing cytology. Statistical analysis of proposed diagnostic criteria. Am J Clin Pathol 1998;110:635-640.PubMedGoogle Scholar
  58. 58.
    Rumalla A, Baron TH, Leontovich O, et al. Improved diagnostic yield of endoscopic biliary brush cytology by digital image analysis. Mayo Clin Proc 2001;76:29-33.PubMedGoogle Scholar
  59. 59.
    Schoefl R, Haefner M, Wrba F, et al. Forceps biopsy and brush cytology during endoscopic retrograde cholangiopancreatography for the diagnosis of biliary stenoses. Scand J Gastroenterol 1997;32:363-368.PubMedGoogle Scholar
  60. 60.
    Selvaggi SM. Biliary brushing cytology. Cytopathology 2004;15: 74-79.PubMedGoogle Scholar
  61. 61.
    Sheehan MM, Fraser A, Ravindran R, McAteer D. Bile duct brushings cytology – improving sensitivity of diagnosis using the Thin-Prep technique: a review of 113 cases. Cytopathology 2007;18:225-233.PubMedGoogle Scholar
  62. 62.
    Stewart CJ, Mills PR, Carter R, et al. Brush cytology in the assessment of pancreatico-biliary strictures: a review of 406 cases. J Clin Pathol 2001;54:449-455.PubMedGoogle Scholar
  63. 63.
    Tascilar M, Sturm PD, Caspers E, et al. Diagnostic p53 immunostaining of endobiliary brush cytology: preoperative cytology compared with the surgical specimen. Cancer 1999;87:306-311.PubMedGoogle Scholar
  64. 64.
    Trent V, Khurana KK, Pisharodi LR. Diagnostic accuracy and clinical utility of endoscopic bile duct brushing in the evaluation of biliary strictures. Arch Pathol Lab Med 1999;123:712-715.PubMedGoogle Scholar
  65. 65.
    Tsui WMS, Lam PWY, Mak CKL, Pay KH. Fine-needle aspiration cytologic diagnosis of intrahepatic biliary papillomatosis (intraductal papillary tumor): report of three cases and comparative study with cholangiocarcinoma. Diagn Cytopathol 2000;22:293-298.PubMedGoogle Scholar
  66. 66.
    Vadmal MS, Byrne-Semmelmeier S, Smilari TF, Haidu SI. Biliary brush cytology. Acta Cytol 2000;44:533-538.PubMedGoogle Scholar
  67. 67.
    Volmar KE, Vollmer RT, Routbort MJ, Creager AJ. Pancreatic and bile duct brushing cytology in 1000 cases: review of findings and comparison of preparation methods. Cancer 2006;108:231-238.PubMedGoogle Scholar
  68. 68.
    Weber A, Schmid RM, Prinz C. Diagnostic approaches for cholangiocarcinoma. World J Gastroenterol 2008;14:4131-4136.PubMedGoogle Scholar
  69. 69.
    Wise L, Pizzimbono C, Dehner LP. Periampullary cancer: a clinicopathologic study of sixty-two patients. Am J Surg 1976;131:141-148.PubMedGoogle Scholar
  70. 70.
    Xing GS, Geng JC, Han XW, et al. Endobiliary brush cytology during percutaneous transhepatic cholangiodrainage in patients with obstructive jaundice. Hepatobiliary Pancreat Dis Int 2005;4:98-103.PubMedGoogle Scholar
  71. 71.
    Yamaguchi K, Enjoji M. Adenoma of the ampulla of Vater: putative precancerous lesion. Gut 1991;32:1558-1561.PubMedGoogle Scholar
  72. 72.
    Ylagan LR, Liu LH, Maluf HM. Endoscopic bile duct brushing of malignant pancreatic biliary strictures: retrospective study with comparison of conventional smear and ThinPrep® techniques. Diagn Cytopathol 2003;28:196-204.PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Peter Spieler
    • 1
  • Matthias Rössle
    • 2
  1. 1.Institut für PathologieKantonsspital St. GallenSt. GallenSwitzerland
  2. 2.Institut für Klinische PathologieUniversitätsSpital ZürichZürichSwitzerland

Personalised recommendations