Urine cytology - Diagnostic Principles and Reporting.pptx

Urine Cytology

1. Urine Cytology

2. The main purpose of urine cytology To detect bladder cancer The Paris System: The main goal is to detect urothelial carcinoma that clinically significant: High grade urothelial carcinoma

3. What can you expect to find in a normal urine? Urothelial cells Intermediate and superficial (umbrella) cells (voided urine) Intermediate, superficial and basal cells (catheterized urine, washing) Squamous cells Miscellaneous findings Prostate and seminal vesicle epithelial cells Renal tubular cells and casts Corpora amylacea Crystals Inflammatory cells Degenerated intestinal epithelial cells (ileal conduit)

4. Umbrella cells Low N/C ratio Pale finely granular chromatin Smooth nuclear shapes Multinucleation common Cytoplasm transparent

5. Intermediate and basal cells

6. Casts

7. Non-Urinary Elements

8. The Paris system

9. Adequacy of Urine Specimens(Adequacy)

10. Negative for high grade urothelial carcinoma A sample of urine, either voided or instrumented, may be considered benign, i.e., NHGUC, if any of the following components are present in the specimen: Benign urothelial, glandular, and squamous cells Benign urothelial tissue fragments (BUTF) and urothelial sheets or clusters Changes associated with lithiasis Viral cytopathic effect; polyoma virus (BK virus— decoy cells) Post therapy effect, including epithelial cells from urinary diversions

11. Umbrella cell

12. Glandular cell Cystitis cystica/ glandularis .

13. Renal tubular cell Benign Urothelial Tissue Fragments

14. Systemic Chemotherapy Changes

15. Atypical Urothelial Cells (AUC)

16. Suspicious for HighGrade Urothelial Carcinoma (Suspicious)

17. HighGrade Urothelial Carcinoma (HGUC)

18. Low Grade Urothelial Neoplasia (LGUN)