Cytologic diagnosis of adenocarcinoma in biliary and pancreatic duct brushings.

Biliary and pancreatic duct brush specimens are relatively uncommon specimens seen by pathologists. Not only can the findings of malignancy be subtle, the implications of a malignant diagnosis can be significant. This review focuses on cholangiocarcinoma and pancreatic ductal adenocarcinoma sampled by endoscopic brush cytology, with an emphasis on diagnostic criteria for adenocarcinoma. In addition, assessment of specimen adequacy, utilization of liquid-based preparations, molecular diagnosis, and timing of liver transplantation in patients with primary sclerosing cholangitis are also briefly discussed.