Urine cytology of nonurothelial malignancies—a 10‐year experience in a large multihospital healthcare system

Abstract

Colon cancer was the most frequent secondary tumor. Sampling error attributed to the false-negative results. Necrosis and dirty background was often associated with metastatic lesions from colon. Obtaining history of a primary tumor elsewhere was a key factor in diagnosis of a metastatic lesion. Hematopoietic malignancies remain to be a diagnostic challenge. Cytospin preparations were superior for evaluating nuclear detail and background material as opposed to monolayer (Thinprep) technology. Diagnostic accuracy was improved by obtaining immunohistochemistry. Diagn. Cytopathol. 2016. © 2016 Wiley Periodicals, Inc. Diagn. Cytopathol. 2017;45:22-28. © 2016 Wiley Periodicals, Inc.

Urine cytology findings in patients with biopsy‐confirmed urothelial carcinoma in situ with plasmacytoid features

“…19 Prostate cancer, when present as single cells in urine cytology, will show eccentric, hyperchromatic nuclei and may occasionally lack nucleoli. 20 Reactive urothelial cells may show increased N/C ratios and nuclear eccentricity on urine cytology, but the presence of cytoplasmic vacuolization is a helpful clue in favoring a reactive change. 21 Melamed-Wolinska bodies may also mimic cytoplasmic globules, but they are very small, tend to be multiple, and are often present in a background of degenerated cells seen in bladder diversion urine.…”

“…Carcinoid tumors of the renal pelvis have been reported in urine cytology and are described as small monolayered sheets of small polygonal cells with ill‐defined cytoplasm, mildly pleomorphic nuclei with chromatin clumping, and small nucleoli 19 . Prostate cancer, when present as single cells in urine cytology, will show eccentric, hyperchromatic nuclei and may occasionally lack nucleoli 20 . Reactive urothelial cells may show increased N/C ratios and nuclear eccentricity on urine cytology, but the presence of cytoplasmic vacuolization is a helpful clue in favoring a reactive change 21 .…”

Malignant Cells in Urine Cytology: Not Always High-Grade Urothelial Carcinoma

“…The most common secondary tumor of the bladder is colon cancer followed by prostate cancer. Colorectal adenocarcinoma typically involves the bladder by direct extension, whereas prostatic adenocarcinoma may involve the urinary tract by local involvement of the prostatic urethra, extension into the bladder, or via lymphatic metastasis 3 . These lesions present a diagnostic challenge in urine cytology, in part due to their rarity, but also due to their morphologic overlap with HGUC.…”

“…Colorectal adenocarcinoma typically involves the bladder by direct extension, whereas prostatic adenocarcinoma may involve the urinary tract by local involvement of the prostatic urethra, extension into the bladder, or via lymphatic metastasis. 3 These lesions present a diagnostic challenge in urine cytology, in part due to their rarity, but also due to their morphologic overlap with HGUC. Key cytomorphologic features to correctly identify these tumors have been previously described.…”