Cytologic difference between benignity and malignancy in suspicious cases employing urine cytodiagnosis using a...

Area of Science:

• Urology
• Cytopathology
• Oncology

Background:

• Liquid-based cytology (LBC) is utilized for urine sample analysis.
• Distinguishing atypical or suspicious cells requires careful morphological evaluation.
• Early detection of urothelial carcinoma is crucial for effective treatment.

Purpose of the Study:

• To compare cell morphology in suspicious liquid-based cytology cases that were ultimately negative versus positive for urothelial carcinoma.
• To identify key morphological features that differentiate benign atypia from malignancy in urine cytology.
• To enhance the diagnostic accuracy of LBC for urothelial carcinoma.

Main Methods:

• Urine cytology performed using LBC on 323 samples.
• Initial screening identified 75 suspicious cases.
• Morphological analysis of suspicious cells from initially identified cases, comparing those later confirmed as positive (5 cases) or negative (8 cases) for cancer.

Main Results:

• Negative cases showed fewer cells with generally weak atypia, swollen pale nuclei, and weak hyperchromatism.
• Positive cases exhibited less pronounced nuclear swelling, flattening, shrinkage, and pale staining compared to negative cases.
• Malignant features included hyperchromatic and irregular nuclei, nuclear cannibalism, multinucleation, anisokaryosis, three-dimensionality, and irregular nuclear arrangement.

Conclusions:

• LBC demonstrates high diagnostic efficiency due to effective cell collection rates.
• Understanding specific cell morphology characteristics in suspicious cases significantly increases the accuracy of LBC diagnoses.
• Morphological assessment is key to improving the reliability of LBC in detecting urothelial carcinoma.