Abstract
This chapter focuses on genitourinary tract cytology, specifically fine needle aspiration (FNA) of the renal mass lesions and urinary tract cytology. FNAs of renal masses have been performed for diagnosis or confirmation of advanced neoplasia and metastases, and/or staging of tumors. In the age of multimodality treatment options (surgery, cryoablation, radiofrequency ablation, etc.), there is a role for precise pretreatment characterization of the renal masses by FNA, which would decrease the unnecessary treatment for benign diseases and reduce the treatment-related mortality and morbidity in addition to reducing the patient care costs. To date, urine cytology remains the gold standard for bladder cancer screening. It has been, and still is the test against which all new tests are compared when evaluating potential bladder tumor markers. In the last 20 years, a number of noninvasive tests have been developed to detect urothelial carcinoma. Although some have been able to show a better sensitivity compared to cytology, only a few have been close to reaching the sensitivity seen in cytology. Combining some of the new markers with cytologic evaluation may optimize their performance status.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Katz RL (1997) Kidneys, adrenals and retroperitoneum. In: Bibbo M, Wilbur DC (eds) Comprehensive cytology, 2nd edn. WB Saunders, Philadelphia, pp 781–821
Renshaw AA, Granter SR, Cibas E (1997) Fine-needle aspiration of the adult kidney. Cancer Cytopath 81:71–88
Volpe A, Kachura JR, Geddie WR, Evans AJ, Gharajeh A, Saravanan A, Jewett M (2007) Techniques, safety and accuracy of sampling of renal tumors by fine needle aspiration and core biopsy. J Urol 178:379–386
Gibbons RP, Bush WH Jr, Burnett LL (1977) Needle tract seeding following aspiration of renal cell carcinoma. J Urol 118:865–867
Kiser GC, Totonchy M, Barry JM (1986) Needle tract seeding after percutaneous aspiration of renal adenocarcinoma. J Urol 136:1292–1293
Shenoy PD, Lakhkar BN, Ghosh MK, Patil UD (1991) Cutaneous seeding of renal carcinoma by Chiba needle aspiration biopsy. Case report. Acta Radiol 32:50
Wehle MJ, Grabstald H (1986) Contraindications to needle aspiration of a solid renal mass: tumor dissemination by renal needle aspiration. J Urol 136:446
Auvert J, Abbou CC, Lavarenne V (1982) Needle tract seeding following puncture of renal oncocytoma. Prog Clin Biol Res 100:597
Abe M, Saitoh M (1992) Selective renal tumour biopsy under ultrasonic guidance. Br J Urol 70:7
Wunderlich H, Hindermann W, Al Mustafa AM, Reichelt O, Junker K Schubert J (2005) The accuracy of 250 fine needle biopsies of renal tumors. J Urol 174:44
Smith EH (1991) Complications of percutaneous abdominal fine-needle biopsy. Review Radiol. 178:253–258
Brierly RD, Thomas PJ, Harrison NW, Fletcher MS, Nawrocki JD, Ashton-Key M (2000) Evaluation of fine-needle aspiration cytology for renal masses. BJU Int 85:14–18
Todd LD, Truong TD, Dhurandhar B, Ramzy I (1999) Fine-needle aspiration of renal masses in adults; analysis of results and diagnostic problems in 108 cases. Diagn Cytopathol 20:339–349
Campbell SC, Novick AC, Herts B, Fischler DF, Meyer J, Levin HS, Chen RN (1997) Prospective evaluation of fine needle aspiration of small, solid renal masses: accuracy and morbidity. Urology 50:25–29
Haubek A, Lundorf E, Lauridsen KN (1991) Diagnostic strategy in renal mass lesions. Scand J Urol Nephrol Suppl 137:35–39
Orell SR, Langlois SL, Marshall VR (1985) Fine needle aspiration cytology in the diagnosis of solid renal and adrenal masses. Scand J Urol Nephrol 19:211–216
Murphy WM, Zambroni BR, Emerson LD (1985) Aspiration biopsy of the kidney. Cancer 56:200–205
Juul N, Torp-Pedersen S, Gronvall S, Holm HH, Koch F, Larsen S (1985) Ultrasonically guided fine needle aspiration biopsy of renal masses. J Urol 133:579–581
Lang EK (1987) Renal cyst puncture studies. Urol Clin North Am 14:91–102
de Kernion JB, Belldegrun A (1992) Renal tumors. In: Campbell MF, Retik AB, Vaughan ED, Walsh PC (eds) Campbell’s Urology, 2nd edn. WB Saunders, Philadelphia, pp 1055–1067
Bosniak MA (1991) Difficulties in classifying cystic lesions of the kidney. Urol Radiol 13:91–93
Truong LD, Krishnan B, Barrios R et al (1995) Renal neoplasms in acquired cystic disease of the kidney. Am J Kidney Dis 26:1–12
Emmet JL, Levine SR, Woolner LB (1963) Co-existence of renal cyst and tumor: incidence of 1007 cases. Br J Urol 35:403–410
Khorsand D (1965) Carcinoma within solitary renal cysts. J Urol 93:440–444
Hughson M, Hennigar G, McManus J (1980) Atypical cysts, acquired renal cystic disease and renal cell tumors in end stage dialysis kidneys. Lab Invest 42:475–480
Nguyen GK, Percutaneous FNA (1987) biopsy cytology of the kidney and adrenal. Pathol Annual 22:163–191
Silverman JF, Gurley AM, Harris JP et al (1991) Fine needle aspiration cytology of renal infarcts. Cytomorphologic findings and potential diagnostic pitfalls in two cases. Acta Cytol 35:736–741
Kruger S, Sotlar K, Kausch I, Horny HP (2005) Expression of KIT (CD117) in renal cell carcinoma and renal oncocytoma. Oncology 68:269–275
Mazal PR, Exner M, Haitel A, Krieger S, Thomson RB, Aronson PS, Susani M (2005) Expression of kidney-specific cadherin distinguishes chromophobe renal cell carcinoma from renal oncocytoma. Hum Pathol 36:22–28
Garcia E, Li M (2006) Caveolin-1 immunohistochemical analysis in differentiating chromophobe renal cell carcinoma from renal oncocytoma. Am J Clin Pathol 125:392–398
Alroy J, Ucci AA, Azabdoaftari G, Banner BF, Cheville JC (2005) Expression of CD3 antigens in renal tubule epithelium and renal oncocytomas. Pathol Res Pract 201:803–808
Mete O, Kilicaslan I, Gulluoglu MG, Uysal V (2005) Can renal oncocytoma be differentiated from its renal mimics? The utility of anti-mitochondrial, caveolin 1, CD63 and cytokeratin 14 antibodies in the differential diagnosis. Virchows Arch 447:938–946
Assad L, Resetkova E, Oliveira VL, Sun W, Stewart JM, Katz RL, Caraway NP (2005) Cytologic features of renal medullary carcinoma. Cancer 1051:28–34
Santamaria M, Jauregui I, Urtasun F, Bertol A (1995) Fine needle aspiration biopsy in urothelial carcinoma of renal pelvis. Acta Cytol 39:443–448
Gattuso P, Ramzy I, Truong LD (1999) Utilization of fine-needle aspiration in the diagnosis of metastatic tumors to the kidney. Diagn Cytopathol 21:35–38
Lambl W Uber Harnblasenkrebs. Einbeitag zur mikroskopischen Diagnostic am Krakenbette. Prager Vierteljahreshift f. Heilkunde. 1865;49:1–15
Sanders WR (1864) Cancer of the bladder. Fragments forming urethral plugs discharged in urine. Concentric colloid bodies. Edinb Med J 10:273–275
Papanicolaou GN, Marshall VF (1945) Urine sediment smears: a diagnostic procedure in cancers of urinary tract. Science 101:519–521
Koss L, Melamed M (2005) In: Koss’ diagnostic cytology and its histopathologic bases, Koss L, Melamed M eds 5th ed. Philadelphia, PA: Lipincott Williams & Wilkins; 2005:38–846
Brown FM (2000) Urine Cytology Is it still the gold standard for screening? Urol Clin North Am 27:25–37
Morse N, Melamed MR (1974) Differential counts of cell populations in urinary sediment from patients with primary epidermoid carcinoma of bladder. Acta Cytol 18:312–315
Murphy WM, Crabtree WN, Jukkola WN, Soloway MS (1981) The diagnostic value of urine versus bladder washing in patients with bladder cancer. J Urol 126:320–322
Wright RG, Halford JA (2001) Evaluation of thin-layer methods in urine cytology. Cytopathology 12:306–313
Elsheikh TM, Kirkpatrick JL, Wu HH (2006) Comparison of ThinPrep and Cytospin preparations in the evaluation of exfoliative cytology specimens. Cancer 108:144–149
Hwang EC, Park SH, Jung SI (2007) etal. Usefulness of liquid-based preparation in urine cytology. Int J Urol 14:626–629
Jemal A, Siegal R, Ward E. et al (2008) Cancer statistics, 2008 CA. Cancer J Clin 58:71–96
Tavora F, Fjardo DA et al (2009) Small endoscopic biopsies of the ureter and renal pelvis: pathologic pitfalls. AJSP 33:1540–1546
Gittes RF (1984) Retrograde brushing and nephroscopy in the diagnosis of upper tract urothelial cancer. Urol Clin North Am 11:617–622
Havens MA, Cabay RJ, Mehrotra S, Kapur U, Wojcik EM, Barkan GA (2009) Upper genitourinary tract cytology: more sensitive than surgical biopsy? Cancer Cytopath 117:371
Coleman DV (1975) The cytodiagnosis of human polyoma virus infection. Acta Cytol 19:93–96
Kahan AV, Coleman DV, Koss LG (1980) Activation of human polyoma virus infection. Detection by cytologic techniques. Am J Clin Pathol 74:326–332
Koss LG, Sherman AB, Eppich E (1984) Image analysis and DNA content of urothelial cells infected with human polyoma virus. Anal Quant Cytol 6:89–94
Koss LG (1995) Cytologic manifestation of benign disorders affecting cells of the lower urinary tract. In: Koss LG (ed) Diagnostic cytology of the urinary tract: with histopathologic and clinical correlation, 1st edn. Lippincott Williams & Wilkins, Philadelphia, pp 52–55
Wojcik EM, Miller MC, Wright BC, Veltri RW, O’Dowd GJ (1997) Comparative analysis of DNA content in Polyoma Virus infected urothelial cells, urothelial dysplasia and transitional cell carcinoma. Anal Quant Cytol Histol 19:430–436
Highman W, Wilson E (1982) Urine cytology in patients with calculi. J Clin Pathol 35:350–356
Rubben H, Hering F, Dahm HH, Lutzeyer W (1982) Value of exfoliative urinary cytology for differentiation between uric acid stone and tumor of upper urinary tract. Urology 22:571–573
Betz SA, See WA, Cohen MB (1993) Granulomatous inflammation in bladder wash specimens after intravesical Bacillus Calmette-Guerin therapy for transitional cell carcinoma of the bladder. Am J Clin Pathol 99:244–248
Forni AM, Koss LG, Geller W (1964) Cytological study of the effect of cyclophosphamide in man. Cancer 17:1348–1355
Murphy WM, Soloway MS, Finebaum PJ (1981) Pathological changes associated with topical chemotherapy for superficial bladder cancer. J Urol 126:461–464
Solomon D, Nayar R, Davey D, Wilbur D, Kurman R (eds.) (2004) In the bethesda system for reporting cervical cytology: definitions, criteria, and explanatory notes, 2nd edn. Springer, New York, pp 1–188
Renshaw AA (2000) Subclassifying atypical urinary cytology specimens. Cancer 90:222–229
Kapur U, Venkataraman G, Wojcik EM (2008) Diagnostic significance of ‘atypia’ in instrumented versus voided urine specimens. Cancer 114:270–274
Raab SS, Grzybicki DM, Vrbin CM, Geisenger KR (2007) Urine cytology discrepancies. Am J Clin Pathol 127:946–953
Bhatia A, Dey P, Kakkar N, Srinivasan R, Nijhawan R (2006) Malignant atypical cell in urine cytology: a diagnostic dilemma. Cyto journal 3:28–33
Deshpande V, McKee GT (2005) Analysis of atypical urine cytology in a tertiary care center. Cancer 105:468–475
Palmer D, Lallu S, Matheson P, Bethwaite P, Tompson K (2007) Karyomegalic interstitial nephritis: a pitfall in urine cytology. Diagn Cytopathol 35:179–182
Epstein JI, Amin MB, Reuter VR, Mostofi FK et al. (1998) for the bladder consensus conference committee. The World Health Organization/International Society of urological pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder. Am J Surg Pathol 22:1435–1448
Badelment RA, Kimmoel M, Gay H, Cibas ES, Whitmore WF Jr, Herr HW, Fair WR, Melamed MR (1987) The sensitivity of flow cytometry compared with conventional cytology in the detection of superficial bladder carcinoma. Cancer 59:2078–2085
Danque PO, Chen HB, Patil J, Jagirdar J, Orsatti G, Paronetto F (1993) Image analysis versus flow cytometry for DNA ploidy quantitation of solid tumors: a comparison of six methods of sample preparation. Mod Pathol 6:270–275
Wojcik EM, Bassler TJ, Orozco R (1999) DNA ploidy of seminal vesicle cells. A potential diagnostic pitfall in urine cytology. Analyt Quant Cytol Histol 21:29–34
Bakhos R, Shankey TV, Fisher S, Flanigan RC, Wojcik EM (2000) Comparative analysis of DNA flow cytometry and cytology of urine barbotages—review of discordant cases. Diagn Cytopathol. 22: 65–69
Wojcik EM, Brownlie RJ, Bassler TJ, Miller MC (2000) Superficial urothelial cells (umbrella cells)—a potential cause of abnormal DNA ploidy results in urine specimens. Analyt Quant Cytol Histol 22:411–415
Hajdinjak T (2008) UroVysion FISH test for detecting urothelial cancers: meta-analysis of diagnostic accuracy and comparison with urinary cytology testing. Urol Oncol 26:646–651
van Rhijn BW, van der Poel HG, van der Kwast TH (2005) Urine markers for bladder cancer surveillance: a systematic review. Eur Urol 47:736–748
Fradet Y, Lockhart C (1997) The immunocyt trialists. Performance characteristics of a new monoclonal antibody test for bladder cancer. ImmunocytT M. Can J Urol 4:400–405
Tetu B (2009) Diagnosis of urothelial carcinoma. Urine Modern Pathol. 22:S53–S59
Melissourgos ND, Kastrinakis NG, Skolarikos A et al (2005) Cytokeratin-20 immunocytology in voided urine exhibits greater sensitivity and reliability than standard cytology in the diagnosis of transitional cell carcinoma of the bladder. Urology 66:536–541
Lokeshwar VB, Soloway MS (2001) Current bladder tumor tests: does their projected utility fulfill clinical necessity? J Urol 165:1067–1077
Grossman HB, Soloway M, Messing E et al (2006) Surveillance for recurrent bladder cancer using a point-of-care proteomic assay. JAMA 295:299–305
Serretta V, Pomara G, Rizzo I et al (2000) Urinary BTA-stat, BTA-trak and NMP22 in surveillance after TUR of recurrent superficial transitional cell carcinoma of the bladder. Eur Urol 38:419–425
Giannopoulos A, Manousakas T, Mitropoulos D et al (2000) Comparative evaluation of the BTAstat test, NMP22, and voided urine cytology in the detection of primary and recurrent bladder tumors. Urology 55:871–875
Shariat SF, Marberger MJ, Lotan Y et al (2006) Variability in the performance of nuclear matrix protein 22 for the detection of bladder cancer. J Urol 176:919–926
Lokeshwar VB, Habuchi T, Grossman HB et al (2005) Bladder tumor markers beyond cytology: International consensus panel on bladder tumor markers. Urology 66:35–63
Hautmann S, Toma M, Lorenzo GMF et al (2004) Immunocyt and the HA-HAase urine tests for the detection of bladder cancer: a side-by-side comparison. Eur Urol 46:466–471
Soloway MS (2008) Possible malignancy after cytology analysis in a 45-year old man. Curr Urol Rep 9:182–184
Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H (2003) Solid renal tumors: an analysis of pathological features related to tumor size. J Urol 170:2217
Gill IS, Matin SF, Desai MM, Kaouk JH, Steinberg A, Mascha E et al (2003) Comparative analysis of laparoscopic versus open partial nephrectomy for renal tumors in 200 patients. J Urol 170:64
Link RE, Bhayani SB, Allaf ME, Varkarakis I, Inagaki T, Rogers C (2005) Exploring the learning curve, pathological outcomes and perioperative morbidity of laparoscopic partial nephrectomy performed for renal mass. J Urol 173:1690
Kroft SH, Oyasu R (1994) Urinary bladder cancer: mechanisms of development and progression. Lab Invest 71:158–174
Soloway MS (1999) Editorial: Do we have a prostate specific antigen for bladder cancer? J Urol 161:447–448
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Barkan, G.A., Wojcik, E.M. (2014). Genitourinary Cytopathology (Kidney and Urinary Tract). In: Nayar, R. (eds) Cytopathology in Oncology. Cancer Treatment and Research, vol 160. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38850-7_7
Download citation
DOI: https://doi.org/10.1007/978-3-642-38850-7_7
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-38849-1
Online ISBN: 978-3-642-38850-7
eBook Packages: MedicineMedicine (R0)