A Review of Recent Advances in Cytopathology for Diagnosis of Hepato-Biliary Lesions

Abstract

Cytology has emerged as an important diagnostic modality for hepato-biliary lesions because of its minimally invasive, rapid turnaround time and cost-effective nature. This is especially important in diagnosis of neoplastic pathology of liver, gall bladder or bile duct where biopsy is difficult and delayed diagnosis may lead to complications or even mortality. The advent of newer molecular diagnostic modalities like polymerase chain reaction (PCR), fluorescent in situ hybridization (FISH), immunochemistry or more recently circulating tumour cells and next generation sequencing (NGS) have not only led to precise diagnosis but are also helpful in targeted therapy and prognostication of tumour. Cytology which is a minimally invasive technique can be judiciously used for advanced molecular analysis for diagnosis and management of hepato-biliary lesions. Awareness regarding the use of cytological samples for molecular analysis in hepato- biliary lesions is essential so that mutational changes may be easily determined without undergoing any invasive technique in these deep-seated lesions. It is also necessary that guidelines on molecular cytology should be chalked out so that uniform reporting is followed with maintenance of high-quality standards.