Abstract
Cytological sampling of the upper luminal gastrointestinal (GI) tract has long been used for the detection of malignant and premalignant lesions and infections. Direct visualization of the mucosa, coupled with ultrasound imaging of submucosal structures, allows for the collection of mucosal brushings, submucosal fine-needle aspirates (FNA), and mucosal biopsies, all with a single procedure. The introduction of nonendoscopic sampling has kindled interest in cytological evaluation of the esophagus for screening of high-risk populations. Cytology specimens have advantages over specimens obtained by endoscopic biopsy. The brush can sample a wider area, and the fine needle can reach deeper lesions than can be reached by biopsy forceps. Also, both the brush and the fine needle are less invasive than biopsy forceps and less likely to cause bleeding. In addition, cytology has a shorter turnaround time than histology. Therefore the cytological technique provides useful supplemental or even alternative samples to endoscopic biopsies for diagnosis of a wide range of entities, both benign and malignant, in the GI tract. This chapter covers cytological specimen types, sample preparations, and illustrative morphology of common and some uncommon entities encountered in the GI tract.
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