Diagnostic Cytology and Its Histopathologic Bases

Koss, Leopold G.; DURFEE, GRACE R.

doi:10.1097/00000441-196112000-00026

Cited by 132 publications

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“…It is less useful in the detection of low-grade urothelial carcinoma, but this can be enhanced by combining urine cytology and some ancillary tests. 10 The cytologic features for many nonneoplastic conditions of the lower urinary tract are non-specific and may result in atypical or false positive diagnoses leading to repeat cystoscopic and biopsy procedures. In the urine of NA patients, small loose clusters and cellular clusters with papillary configurations can been seen and the initial diagnosis is usually ''atypical.''…”

Section: Discussionmentioning

confidence: 99%

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Nephrogenic adenoma identified on urine cytology using PAX‐2 immunostaining

Herlitz

Tong

Hamele‐Bena

et al. 2007

Diagnostic Cytopathology

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Urine cytology is a sensitive and specific method in detecting urothelial carcinoma of the urinary bladder, particularly the high-grade ones. However, the cytologic features of nonneoplastic lesions of the lower urinary tract, including nephrogenic adenoma, are nonspecific and may cause false positive diagnosis. Recent evidence has demonstrated that nephrogenic adenoma is a true ''nephrogenic'' lesion derived from the exfoliated and implanted renal tubular cells in the urinary tract. This has promoted the use of immunostaining of renal transcription factor PAX2 in tissue biopsies to differentiate nephrogenic adenoma from the common malignant tumors of the lower urinary tract. We report here that PAX2 immunostaining can also be used in urine cytology specimen to identify nephrogenic adenoma. Combination of PAX2 immunostaining and cytologic analysis may increase the accuracy in identifying this benign lesion in urine cytology specimen and therefore reduce unnecessary repeat cystoscopy and biopsy procedures. This may be a cost effective followup method for patients with an established diagnosis of nephrogenic adenoma. Diagn. Cytopathol. 2008;36:47-49. ' 2007 Wiley-Liss, Inc.Key Words: PAX2; nephrogenic adenoma; urine cytology Nephrogenic adenoma (NA) is an uncommon lesion of the urinary tract often associated with renal transplant, anatomic anomaly, or a history of traumatic injury of the urinary tract. 1 It was traditionally considered to be a metaplastic lesion of the urothelium. However, recent evidence has suggested that NA is a truly ''nephrogenic'' lesion derived from exfoliated and implanted renal tubular cells in the urinary tract. 2 The histologic features of NA are well described and the diagnoses in most cases are straightforward. 3-5 Urine cytology is frequently used to evaluate urinary bladder cancer and constitutes a large portion of cytology specimens. However, the cytologic features of NA are less well defined and it contributes to false positive diagnoses in urine cytology. [6][7][8] In addition, NA may coexist with or develop after the treatment of malignant tumors of the urinary tract, thus further complicating the recognition of this benign lesion. Several immunohistochemical markers have been used to assist in the differential diagnosis of NA. Recently, we reported that the renal transcription factor PAX2 is a reliable marker to distinguish NA from common carcinomas of the urinary tract on tissue sections. 9 We report here our experience utilizing PAX2 antibody in a urine cytology specimen for one NA case. Report of a CaseThe patient was a 69-year-old woman with end stage renal disease secondary to diabetes and hypertension who was on a waiting list for kidney transplant. A 3-cm tumor was noted on the right lateral wall of the urinary bladder during the pretransplant evaluation. The patient underwent a partial cystectomy and the tumor was reportedly resected completely. The histological diagnosis was lowgrade papillary urothelial carcinoma, which resulted in her subsequent removal from the tra...

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Section: Discussionmentioning

confidence: 99%

“…10 Some renal tumors, such as collecting duct carcinoma and papillary renal cell carcinomas have a high predilection to involve in the renal pelvis. 16,18 Although the cells of renal cell carcinomas may also have vacuolated cytoplasm, the nuclei are overtly malignant, with irregular, hyperchromatic nuclei, and prominent nucleoli.…”

Section: Discussionmentioning

confidence: 99%

Nephrogenic adenoma identified on urine cytology using PAX‐2 immunostaining

Herlitz

Tong

Hamele‐Bena

et al. 2007

Diagnostic Cytopathology

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“…6 Sometimes benign and malignant lesions cannot be discriminated by morphology with certainty, and reactive changes of bronchial and alveolar epithelium, air-drying artifacts during smear preparation, and poorly preserved specimens sometimes impede or even render a distinct cytological diagnosis impossible. [7][8][9][10] Accordingly, cytology sometimes leaves an equivocal (2.9% of cases in a single institution; 8.6% from a single hospital during a 9-month period in our institution) or inconclusive result even in the hands of experienced observers. 5,11,12 To prevent repeated diagnostic efforts and potentially harmful invasive diagnostic procedures, it is essential to enhance diagnostic accuracy in these cases.…”

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confidence: 69%

Equivocal cytology in lung cancer diagnosis

Schramm

Wrobel

Born

et al. 2011

Cancer Cytopathology

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BACKGROUND:Sometimes, cytological lung cancer diagnosis is challenging because equivocal diagnoses are common. To enhance diagnostic accuracy, fluorescent in situ hybridization (FISH), DNA‐image cytometry, and quantitative promoter hypermethylation analysis have been proposed as adjuncts.METHODS:Bronchial washings and/or brushings or transbronchial fine‐needle aspiration biopsies were prospectively collected from patients who were clinically suspected of having lung carcinoma. After routine cytological diagnosis, 70 consecutive specimens, each cytologically diagnosed as negative, equivocal, or positive for cancer cells, were investigated with adjuvant methods. Suspicious areas on the smears were restained with the LAVysion multicolor FISH probe set (Abbott Molecular, Des Plaines, Illinois) or according to the Feulgen Staining Method for DNA‐image cytometry analysis. DNA was extracted from residual liquid material, and frequencies of aberrant methylation of APC, p16INK4A, and RASSF1A gene promoters were determined with quantitative methylation‐specific polymerase chain reaction (QMSP) after bisulfite conversion. Clinical and histological follow‐up according to a reference standard, defined in advance, were available for 198 of 210 patients.RESULTS:In the whole cohort, cytology, FISH, DNA‐image cytometry, and QMSP achieved sensitivities of 83.7%, 78%, 79%, and 49.6%, respectively (specificities of 69.8%, 98.2%, 98.2%, and 98.4%, respectively). Subsequent to cytologically equivocal diagnoses, FISH, DNA‐image cytometry, and QMSP definitely identified malignancy in 79%, 83%, and 49%, respectively. With QMSP, 4 of 22 cancer patients with cytologically negative diagnoses were correctly identified.CONCLUSIONS:Thus, adjuvant FISH or DNA‐image cytometry in cytologically equivocal diagnoses improves diagnostic accuracy at comparable rates. Adjuvant QMSP in cytologically negative cases with persistent suspicion of lung cancer would enhance sensitivity. Cancer (Cancer Cytopathol) 2011;. © 2011 American Cancer Society.

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“…Para as demais colorações, Giemsa, Gomori-Grocott, Ziehl-Nielsen e Gram, a fixação das células se deu por secagem ao ar ambiente (Koss, 1992).…”

Section: Methodsunclassified

Lavagem traqueobrônquica por sondagem nasotraqueal em bezerros

Gonçalves

Mattos

Kuchembuck

et al. 2004

Arq. Bras. Med. Vet. Zootec.

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RESUMOAvaliou-se a técnica de lavagem traqueobrônquica por sondagem nasotraqueal e caracterizou-se a população celular em 10 bezerros clinicamente sadios. Após a contenção dos animais em decúbito lateral e auxílio de sonda guia, foi introduzida uma sonda de menor diâmetro até a bifurcação da traquéia, para produzir tosse e obter o lavado traqueobrônquico. A média de células totais nas amostras de lavado foi de 133.750 células/ml. À citologia, foram observados na contagem diferencial: 77,2% macrófagos, 14,9% células epiteliais cilíndricas, 6,0% neutrófilos e 1,8% linfócitos. Das células epiteliais cilíndricas, 79,0% eram do tipo ciliadas e 21,0% não-ciliadas. A média de contagem de macrófagos binucleados foi de 78,5 células/lâmina, a de macrófagos trinucleados de 20,5/lâmina e a de células gigantes 28,5/lâmina. Concluiu-se que o método de colheita por sondagem nasotraqueal é eficiente para caracterizar a citologia do lavado traqueobrônquico de bezerros clinicamente sadios.

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Diagnostic Cytology and Its Histopathologic Bases

Cited by 132 publications

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Nephrogenic adenoma identified on urine cytology using PAX‐2 immunostaining

Nephrogenic adenoma identified on urine cytology using PAX‐2 immunostaining

Equivocal cytology in lung cancer diagnosis

Lavagem traqueobrônquica por sondagem nasotraqueal em bezerros

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