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Cytologic evaluation of low grade transitional cell carcinoma and instrument artifact in bladder washings
Young Chae Chu1, Jee Young Han, Hye Seung Han
1Departments of Anatomical Pathology and Urology, Inha University Hospital, 7-206, 3rd Street, Shinheung-Dong, Choong-Gu, Inchon, Korea 400-103.
Objective:
To identify key cytologic features for the separation of low grade transitional cell carcinomas (TCCs) from nonneoplastic lesions in bladder washings.
Study Design:
The cytomorphologic features of 95 bladder washing specimens showing papillary fragments, which included 50 low grade TCCs and 45 nonneoplastic lesions, were reviewed retrospectively.
Results:
Bladder washings from low grade TCCs showed papillary and irregular groups of cells with ragged borders, cytoplasmic homogeneity and subtle nuclear changes, such as increased nuclear/cytoplasmic ratio and irregular nuclear border. Bladder washings after instrumentation from nonneoplastic lesions of the bladder showed cellular specimens with cohesive, ball-shaped and papillary clusters with smooth borders lined with a denser-staining cytoplasmic collar. Reactive urothelial cells often displayed loose aggregates with irregular borders but no cytoplasmic collar.
Conclusion:
In bladder washing cytology, nuclear changes and cytoplasmic homogeneity play a major role in the diagnosis of carcinoma.