Cytohistological study of urinary bladder neoplasms.

Area of Science:

• Urology
• Oncology
• Cytopathology

Background:

• Transitional cell carcinoma (TCC) of the bladder is a significant health concern.
• Accurate initial diagnosis and effective follow-up are crucial for patient management.
• Cytology offers a minimally invasive approach for bladder cancer assessment.

Purpose of the Study:

• To evaluate the diagnostic role of exfoliative (voided urine) and saline lavage cytology.
• To compare the efficacy of these two cytological methods in initial diagnosis and follow-up of bladder cancer.
• To assess the correlation between cytological findings, tumor grade, and histological results.

Main Methods:

• Study included 80 patients with painless hematuria and 24 with TCC undergoing follow-up.
• Collected voided urine and saline bladder lavage samples.
• Performed cystoscopy with biopsies, and cytological/histological analysis using Hematoxylin and Eosin and PAP stains.

Main Results:

• A significant correlation (p < 0.001) was found between increasing malignancy grade and cytopositivity.
• Good association (p < 0.01) observed between histology and both cytology methods.
• Lavage cytology showed superior sensitivity (71.05%), specificity (56.0%), and accuracy (78.85%) compared to exfoliative cytology (47.37%, 41.18%, 61.54%).
• Higher positivity noted with single sessile tumors versus multiple pedunculated tumors.
• Cytohistological discrepancies occurred in recurrent TCC cases.

Conclusions:

• Cytology, particularly lavage cytology, is a valuable adjunct to histology for bladder cancer diagnosis.
• It aids in detecting early flat lesions and monitoring patients during follow-up.
• Lavage cytology offers improved diagnostic performance over exfoliative cytology for TCC.