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Difference between revisions of "Urine cytopathology"
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===Cytology=== | ===Cytology=== | ||
Features:<ref>{{Ref APBR|682}}</ref> | Features:<ref>{{Ref APBR|682}}</ref> | ||
#Hyperchromasia - '''low power''' feature. | #Hyperchromasia - '''low power''' feature. | ||
#Irregular nuclear membrane - '''key feature'''. | #Irregular nuclear membrane - '''key feature'''. | ||
#Increased NC ratio. | #Increased NC ratio. | ||
#*Often uniform - when comparing malignant cells. | #*Often uniform - when comparing malignant cells. | ||
#"Large nuclei" (3-4X the size of a normal urothelial cell) - '''low power''' feature. | |||
#*These are not required for the diagnosis.<ref>SM. 12 January 2010.</ref> | |||
#*Large nuclei may be seen in benign umbrella cell, where the [[NC ratio]] is normal. | |||
#Nuclear size variation, >=2X other malign. looking cells - very useful. | #Nuclear size variation, >=2X other malign. looking cells - very useful. | ||
#+/-Large irregular nucleoli - common. | #+/-Large irregular nucleoli - common. | ||
Minimal criteria: | Minimal criteria: | ||
*Criteria # | *Criteria #1-3. † | ||
Notes: | Notes: | ||
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**If features of squamous differentiation are present one calls ''urothelial carcinoma with squamous features''. | **If features of squamous differentiation are present one calls ''urothelial carcinoma with squamous features''. | ||
† Willner ''et al.'' require all of the following:<ref name=pmid33088909>{{cite journal | | DDx: | ||
*Degeneration. | |||
*Polyomavirus. | |||
† Willner ''et al.'' require all of the following:<ref name=pmid33088909>{{cite journal |authors=Willner J, Matloob A, Colanta A, Khader SN |title=Educational Case: Urothelial Carcinoma: An Overview of Pathologic Diagnosis |journal=Acad Pathol |volume=7 |issue= |pages=2374289520958172 |date=2020 |pmid=33088909 |doi=10.1177/2374289520958172 |url=}}</ref> | |||
#Nucleus-to-cytoplasm ratio >0.7. | #Nucleus-to-cytoplasm ratio >0.7. | ||
#Hyperchromasia (moderate or severe). | #Hyperchromasia (moderate or severe). | ||
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#Coarse chromatin. | #Coarse chromatin. | ||
Willner's criteria can be remember by ''CHIN'' = '''''c'''oarse chromatin, '''h'''yperchromasia, '''i'''rregular nuclear membrane, '''N'''C ratio increased''. | |||
==Schistosoma== | ==Schistosoma== | ||
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</gallery> | </gallery> | ||
==Trichomonas== | |||
{{Main|Gynecologic_cytopathology#Trichomoniasis}} | |||
*Trichomonas is found in approximately 0.1% of urine cytology specimens.<ref>{{cite journal |authors=Doxtader EE, Elsheikh TM |title=Diagnosis of trichomoniasis in men by urine cytology |journal=Cancer Cytopathol |volume=125 |issue=1 |pages=55–59 |date=January 2017 |pmid=27636204 |doi=10.1002/cncy.21778 |url=}}</ref> | |||
==Atypical squamous cells in urine== | |||
*Atypical squamous cells in urine cytology specimens are rare ~ 0.3%.<ref>{{cite journal |authors=Velez Torres JM, Zhao J, Epstein JI, Kryvenko ON |title=Condyloma acuminatum of the urinary tract demonstrates atypical squamous cells in urine cytology |journal=Hum Pathol |volume=130 |issue= |pages=110–116 |date=December 2022 |pmid=36244465 |doi=10.1016/j.humpath.2022.10.006 |url=}}</ref> | |||
*An older series describes an association with SCC/UCC of the bladder and SCC of the cervix.<ref>{{cite journal |authors=Owens CL, Ali SZ |title=Atypical squamous cells in exfoliative urinary cytology: clinicopathologic correlates |journal=Diagn Cytopathol |volume=33 |issue=6 |pages=394–8 |date=December 2005 |pmid=16299739 |doi=10.1002/dc.20344 |url=}}</ref> | |||
<pre> | |||
Atypical squamous cells present, see comment. | |||
Benign urothelial cells present in background. | |||
Negative for High-Grade Urothelial Carcinoma. | |||
Comment: | |||
Due to the atypical squamous cells, consideration of further work-up is suggested within the clinical context, based on reported associations.[1] | |||
1. Diagn Cytopathol. 2005 Dec;33(6):394-8. doi: 10.1002/dc.20344 - https://pubmed.ncbi.nlm.nih.gov/16299739/ | |||
</pre> | |||
==See also== | ==See also== | ||
*[[Cytopathology]]. | *[[Cytopathology]]. | ||