FISHing for pancreatobiliary tract malignancy in endoscopic brushings enhances the sensitivity of routine cytology

E. G. Barr Fritcher, B. R. Kipp, K. C. Halling, A. C. Clayton

Research output: Contribution to journalReview articlepeer-review

20 Scopus citations


Pancreatobiliary tract carcinoma is a lethal disease with low survival rates and limited treatment options. Diagnosis is complicated by benign conditions that can mimic malignancy on radiological studies (e.g. primary sclerosing cholangitis or PSC) and the suboptimal sensitivity of endoscopic biopsy/brushings obtained by endoscopic retrograde cholangiopancreatography (ERCP). The detection of multiple chromosomal gains by fluorescence in situ hybridization (FISH), referred to as polysomy, has demonstrated improved sensitivity over routine cytological evaluation. The evaluation of brushings by both routine cytology and FISH in our cytopathology laboratory has been in clinical practice since 2003. Strong morphological and screening skills enable cytotechnologists to become proficient in the assessment of FISH slides, which translates into cost and time savings. Multiple reports from various institutions have demonstrated the utility of FISH for patients with and without PSC. The incorporation of routine cytology and FISH results into the management algorithm for patients under suspicion for pancreatobiliary malignancy is a testament to the clinical success of these cytological assays.

Original languageEnglish (US)
Pages (from-to)288-301
Number of pages14
Issue number5
StatePublished - 2014


  • Cholangiocarcinoma
  • ERCP
  • Endoscopic retrograde cholangiopancreatography
  • Fluorescence in situ hybridization
  • Pancreatobiliary carcinoma
  • Polysomy

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology


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