Distinction of intestinal and diffuse types of XXXX on brush cytology.

@entity1 @entity420 @entity356
OBJECTIVE: To distinguish between the intestinal and diffuse types of @entity356 on brush cytology (BC). STUDY DESIGN: Brushing smears and biopsy samples obtained at endoscopic examination from 32 @entity1 with clinically or radiologically suspected @entity356 were included in the study. Cytologic smears were examined by 2 cytopathologists, using predetermined criteria to arrive at a consensus diagnosis. A meticulous attempt was made to distinguish between the 2 types of @entity356 . Cytologic diagnoses were correlated with the histologic diagnoses. RESULTS: Twenty-one cases (65.6%) were concordant between BC and endoscopic biopsy (EB) with respect to sub-typing. Two (6.2%) cases reported as 'poorly differentiated @entity420 ' on BC turned out to be 'diffuse type'. Three cases (9.4%) reported as 'diffuse type' on BC were 'intestinal type' on EB. Two of these discordant cases had intestinal metaplasia on BC, which should have suggested 'intestinal type' of @entity420 on BC. Three cases (9.4%) were false positive. On review, 2 of these false-positive cases showed cytologically convincing malignant cells, the third case was misinterpreted as diffuse type of @entity420 due to reactive glandular cells entangled in the mucoid background. Three (9.4%) EB were non-representative with only superficial mucosa; BC diagnosis in these 3 cases was intestinal type of @entity420 . CONCLUSION: Although, overlapping cytomorphology between the intestinal and diffuse types of @entity356 can cause diagnostic problem; with a meticulous cytomorphologic approach, it is possible to accurately distinguish between the 2 types in a considerable number of cases.
