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Exfoliative cytology has a high number of false-negative results.
Multiple sampling for exfoliative cytology has been shown to improve the sensitivity of the technique but is time consuming.
Exfoliative cytology: A procedure to collect cells from the lip or oral cavity.
The diagnosis is usually made based on the clinical appearance alone, but oral exfoliative cytology has been used as a diagnostic aid.
Exfoliative cytology can be performed on esophageal lavage obtained by esophagoscopy.
Exfoliative cytology was negative in all 15 patients with benign disease resulting in no false positive results and a specificity of 100%.
We have reviewed our experience of exfoliative cytology in the management of patients with biliary tract strictures.
Unlike duodenal aspiration cytology, bile exfoliative cytology is generally 100% specific (no false positive results).
Samples for exfoliative cytology are simple to obtain, the results are highly specific and should be a routine part of the investigation of biliary strictures.
In 1954 he published another memorable work, the Atlas of Exfoliative Cytology, thus creating the foundation of the modern medical specialty of cytopathology.
Despite this initial success the popularity of exfoliative cytology declined because of occasional reporting of false positive results, caused by degenerative cellular changes in the duodenal juice.
It is now over 40 years since exfoliative cytology was first used for the diagnosis of pancreatobiliary disease, Lemon and Byrne diagnosing pancreatic cancer from cells exfoliated into the duodenum.
With cholangiocarcinomas the reported diagnostic sensitivity of exfoliative cytology varies from 44-100% and may depend on the method and site of sampling as well as its timing during the biliary manipulation.
We would conclude from this study that exfoliative cytology for biliary strictures is simple to perform, highly specific, able to provide a diagnosis when other methods fail and should, therefore, be carried out routinely.
Exfoliative Cytology - In this method, cells are collected after they have been either spontaneously shed by the body ("spontaneous exfoliation") or manually scraped/brushed off of a surface in the body ("mechanical exfoliation").
In contrast with most other studies on exfoliative cytology for bile duct strictures this study has not focused on a particular primary site of tumour but rather the overall use of cytology with biliary strictures.
Suggested reasons for the high false negative rate on exfoliative cytology of pancreatic cancer include the enzymatic digestion of cells, pancreatic duct stenoses, intramural or extramural tumour growth and the distance between the sampling site and the tumour.