The World Health Organization Reporting System for Pancreaticobiliary Cytopathology: Overview and Summary

Autores da FMUP

• 

  Fernando Carlos De Landér Schmitt

  Autor

Participantes de fora da FMUP

• Centeno B.A.
• Saieg M.
• Siddiqui M.T.
• Perez-Machado M.
• Layfield L.J.
• Weynand B.
• Reid M.D.
• Stelow E.B.
• Lozano M.D.
• Fukushima N.
• Cree I.A.
• Mehrotra R.
• Field A.S.
• Pitman M.B.

Unidades de investigação

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Patologia

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

The recently published WHO Reporting System for Pancreaticobiliary Cytopathology (World Health Organization [WHO] System) is an international approach to the standardized reporting of pancreaticobiliary cytopathology, updating the Papanicolaou Society of Cytopathology System for Reporting Pancreaticobiliary Cytology (PSC System). Significant changes were made to the categorization of benign neoplasms, intraductal neoplasms, mucinous cystic neoplasms, and malignant neoplasms considered low grade. Benign neoplasms, such as serous cystadenoma, categorized as Neoplastic: benign in the PSC system, are categorized as Benign/negative for malignancy in the WHO system. Pancreatic neuroendocrine tumor, solid-pseudopapillary neoplasm, and gastrointestinal stromal tumor, categorized as Neoplastic: other in the PSC system, are categorized as Malignant in the WHO System in accord with their classification in the 5th edition WHO Classification of Digestive System Tumours (2019). The two new categories of Pancreaticobiliary Neoplasm Low-risk/grade and Pancreaticobiliary Neoplasm High-risk/grade are mostly limited to intraductal neoplasms and mucinous cystic neoplasms. Low-risk/grade lesions are mucinous cysts, with or without low-grade epithelial atypia. High-risk/grade lesions contain neoplastic epithelium with high-grade epithelial atypia. Correlation with clinical, imaging, and ancillary studies remains a key tenet. The sections for each entity are written to highlight key cytopathological features and cytopathological differential diagnoses with the pathologist working in low resource setting in mind. Each section also includes the most pertinent ancillary studies useful for the differential diagnosis. Sample reports are provided for each category. Finally, the book provides a separate section with risk of malignancy and management recommendations for each category to facilitate decision-making for clinicians. © 2024 American Cancer Society.

© 2024 American Cancer Society.

Keywords

• Biliary Tract Neoplasms; Cytodiagnosis; Cytology; Humans; Pancreatic Neoplasms; World Health Organization; bile duct tumor; cancer grading; cancer risk; clinical decision making; clinical feature; clinician; cytopathology; diagnostic imaging; differential diagnosis; epithelium; fluorescence in situ hybridization; health care planning; high risk population; human; immunocytochemistry; low risk population; pancreatic intraductal neoplasia; pancreatic mucinous cystadenoma; pathologist; patient care; patient triage; Review; tumor classification; World Health Organization; biliary tract tumor; cytodiagnosis; cytology; diagnosis; pancreas tumor; pathology; procedures