Benign and Malignant Exfoliated Gastrointestinal Mucosal Cells

The first attempt to diagnose gastrointestinal cancer by means of microscopic examination of the gastric content was made by such famous pathologists and clinicians as Rosenbach,1Ewald,2Boas,3Rosenheim,4Reineboth,5and Cohnheim.6In 1909 Marini7reported that he had been able to diagnose 32 of 37 gastric cancers by means of the appearance of the unstained cells obtained by meticulous lavage. His excellent descriptions show that he understood the problem thoroughly. Marini predicted that "The day will come when physicians are as certain of the advantages of cytodiagnosis by lavage as they now are of the examination of the urinary sediment." With the advent, however, of the radiologic and endoscopic methods of diagnosis, cytology was forgotten for the next five decades. The revival of the procedure in recent years resulted primarily from the interest of Papanicolaou8and Meigs9and their associates