Research Article

Genetic Abnormalities in Biliary Brush Samples for Distinguishing Cholangiocarcinoma from Benign Strictures in Primary Sclerosing Cholangitis

Figure 1

Representative examples of conventional cytology and DNA FISH of biliary brushing specimens. ((a) and (b)) Conventional cytology. (a) Reactive changes in the context of PSC with some architectural irregularity, mild variation in nuclear size, and overall intact nuclear to cytoplasmic ratio. (b) Adenocarcinoma in a patient with underlying PSC showing hyperchromatic nuclei, marked variation in nuclear shape and size with nuclear molding, and severely disturbed nuclear to cytoplasmic ratio. In the background, necrotic debris with degenerative cells and granulocytes are observed. ((c) and (d)) Representative examples of FISH signal patterns seen in biliary strictures with probes for CEP7 [aqua], CEP17 [green], 20q [gold], and MYC [red]. (c) A normal cell (2 signals of each probe) and (d) gain of MYC (>2 red signals) and gain of CEP7 (>2 blue signals).
(a)
(b)
(c)
(d)