Diagnostic Utility of Cytological Examination in Neoplastic Lesions of Pancreas and Biliary Tract

Cytology plays a crucial role in the diagnosis of neoplastic lesions within the pancreatobiliary system. This prospective diagnostic test accuracy study aimed to evaluate the effectiveness of pre- and intra-operative cytology in diagnosing these lesions. Over two years, cytology samples were obtained from 166 patients with clinicoradiological suspicions of pancreaticobiliary pathology, using histopathology as the gold standard. The study found a sensitivity of 75% and a positive predictive value (PPV) of 96% for fine-needle aspiration cytology (FNAC) in pancreatic lesions. In gallbladder malignancies, FNAC demonstrated a sensitivity of 100%. However, the sensitivity for ampullary and cholangiocarcinoma lesions was comparatively lower, at 40% and 50%, respectively. Overall, cytological examination yielded a diagnostic sensitivity of 52% and a PPV of 98%. Thus, FNAC emerges as a potent diagnostic tool for pancreatic and gallbladder lesions, while bile cytology is vital for inaccessible bile duct malignancies.