Urine cytology
Author:
Mikael Häggström [note 1]
Clinical information
It is not necessary to look through more than readily available reports from previous urine cytologies.
Evaluation
Mainly look for:
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Reactive urothelial changes, Pap stain, showing urothelial cells with enlarged nuclei but a nucleus-cytoplasm ratio of less than 0.5. There are bacteria, as well as an inflammatory response of neutrophils, providing a cause for the changes. Can be reported as "Benign urothelial cells, neutrophils and bacteria".
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High-grade urothelial carcinoma. Cytologic diagnosis of high-grade urothelial carcinoma requires > 10 cells with high N/C ratio, irregular chromatin pattern and hyperchromatic nuclei (Pap stain).[1]
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Distinguish urothelial carcinoma from decoy cells, which are virally infected epithelial cells (Pap stain).
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Also report the presence of red blood cells (here seen compared to benign urothelial cells, Pap stain).
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The N/C ratios apply to the finding of any cells meeting the criteria, and not the average among atypical cells (in the majority of obviously positive cases, N/C/ratio averages 0.5).[2] When there are obvious features of malignancy, there is no need to hunt for cells that fulfil all criteria to make such diagnosis.[2]
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Nuclear/cytoplasmic ratios.
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Fibrovascular cores weakly indicate a urothelial neoplasm, but can be present in all Paris System categories.
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Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ Wang Y, Auger M, Kanber Y, Caglar D, Brimo F (2018). "Implementing The Paris System for Reporting Urinary Cytology results in a decrease in the rate of the "atypical" category and an increase in its prediction of subsequent high-grade urothelial carcinoma. ". Cancer Cytopathol 126 (3): 207-214. doi:. PMID 29278461. Archived from the original. .
- ↑ 2.0 2.1 2.2 - Image by Mikael Häggström. Reference: Wojcik EM, Kurtycz DFI, Rosenthal DL (2022). "We'll always have Paris The Paris System for Reporting Urinary Cytology 2022. ". J Am Soc Cytopathol 11 (2): 62-66. doi:. PMID 35094954. Archived from the original. .
Image sources