Skip to main content

Urine Cytology

  • Chapter
  • First Online:
Practical Cytopathology

Part of the book series: Practical Anatomic Pathology ((PAP))

  • 1243 Accesses

Abstract

Urine cytology remains the single most practical tool to detect and follow up bladder carcinoma, especially for high-grade urothelial carcinoma. The introduction and continued acceptance of the Paris System for Reporting Urinary Cytology will certainly improve the sensitivity and specificity of urine cytology for high-grade urothelial carcinoma diagnosis. In this chapter, we start with questions about urine cytology commonly encountered in cytology practice: from specimen preparation to recognizing the cellular and noncellular components of urine specimens in voided, instrumented, and loop urine samples. We then move on to describe benign reactive changes of urothelial cells, low-grade urothelial neoplasms, and high-grade urothelial carcinomas; common urothelial carcinoma mimics like “decoy” cells and metastatic urinary tract carcinomas are also discussed. The case presentation at the end of the chapter will further emphasize the key concepts and diagnostic points.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Cibas ES, Ducatman BS. Cytology: diagnostic principles and clinical correlates. 4th ed. Philadelphia: Saunders/Elsevier; 2014.

    Google Scholar 

  2. Jensen CS, Cohen MB. Chapter 6: Urinary tract cytopathology. In: Atlas of diagnostic cytopathology. 2nd ed. Philadelphia: Saunders; 2004. p. 232–71.

    Google Scholar 

  3. Thiryayi SA, Rana DN. Urine cytopathology: challenges, pitfalls, and mimics. Diagn Cytopathol. 2012;40(11):1019–34.

    Article  CAS  Google Scholar 

  4. http://hologic.ca/sites/default/files/.

  5. Hundley AF, Maygarden S, Wu JM, Visco AG, Connolly A. Adequacy of urine cytology specimens: an assessment of collection techniques. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(9):997–1001.

    Article  Google Scholar 

  6. Prather J, Arville B, Chatt G, et al. Evidence-based adequacy criteria for urinary bladder barbotage cytology. J Am Soc Cytopathol. 2015;4:57–62.

    Article  Google Scholar 

  7. Barkan GA. Enough is enough: adequacy of voided urine cytology. Cancer Cytopathol. 2016;124(3):163–6.

    Article  Google Scholar 

  8. Vanden Bussche CJ, Rosenthal DL, Olson MT. Adequacy in voided urine cytology specimens: the role of volume and a repeat void upon predictive values for high-grade urothelial carcinoma. Cancer Cytopathol. 2016;124(3):174–80.

    Article  Google Scholar 

  9. Renshaw AA, Gould EW. Evidence-based adequacy criteria for instrumented urine cytology using cytospin preparations. Diagn Cytopathol. 2018;46:520–1. https://doi.org/10.1002/dc.23890.

    Article  PubMed  Google Scholar 

  10. Barkan GA, Wojcik EM, Nayar R, Savic-Prince S, Quek ML, Kurtycz DF, Rosenthal DL. The Paris system for reporting urinary cytology: the quest to develop a standardized terminology. Acta Cytol. 2016;60(3):185–97.

    Article  Google Scholar 

  11. Hattori M, Nishimura Y, Toyonaga M, Kakinuma H, Matsumoto K, Ohbu M. Cytological significance of abnormal squamous cells in urinary cytology. Diagn Cytopathol. 2012;40(9):798–803.

    Article  Google Scholar 

  12. Massaro PA, Moore J, Rahmeh T, Morse MJ. Squamous cell carcinoma of the suprapubic tract: a rare presentation in patients with chronic indwelling urinary catheters. Can Urol Assoc J. 2014;8(7–8):E510–4.

    Article  Google Scholar 

  13. Mostafa MH, Sheweita SA, O’Connor PJ. Relationship between schistosomiasis and bladder cancer. Clin Microbiol Rev. 1999;12(1):97–111.

    Article  CAS  Google Scholar 

  14. Nasuti JF, Fleisher SR, Gupta PK. Significance of tissue fragments in voided urine specimens. Acta Cytol. 2001;45(2):147–52.

    Article  CAS  Google Scholar 

  15. Onur I, Rosenthal DL, VandenBussche CJ. Benign-appearing urothelial tissue fragments in noninstrumented voided urine specimens are associated with low rates of urothelial neoplasia. Cancer Cytopathol. 2015;123(3):180–5.

    Article  Google Scholar 

  16. Doxtader EE, Elsheikh TM. Diagnosis of trichomoniasis in men by urine cytology. Cancer Cytopathol. 2017;125(1):55–9.

    Article  Google Scholar 

  17. Nakashima K, Shigehara K, Kawaguchi S, Wakatsuki A, Kobori Y, Nakashima K, Ishii Y, Shimamura M, Sasagawa T, Kitagawa Y, Mizokami A, Namiki M. Prevalence of human papillomavirus infection in the oropharynx and urine among sexually active men: a comparative study of infection by papillomavirus and other organisms, including Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma spp., and Ureaplasma spp. BMC Infect Dis. 2014;14:43.

    Article  Google Scholar 

  18. Singh HK, Bubendorf L, Mihatsch MJ, et al. Urine cytology findings of polyomavirus infections. In: Madame curie bioscience database [internet]. Austin: Landes Bioscience; 2000–2013. Available from: https://www.ncbi.nlm.nih.gov/books/NBK6541/.

  19. Herawi M, Parwani AV, Chan T, Ali SZ, Epstein JI. Polyoma virus-associated cellular changes in the urine and bladder biopsy samples: a cytohistologic correlation. Am J Surg Pathol. 2006;30(3):345–50.

    Article  Google Scholar 

  20. Kipp BR, Sebo TJ, Griffin MD, Ihrke JM, Halling KC. Analysis of polyomavirus-infected renal transplant recipients’ urine specimens: correlation of routine urine cytology, fluorescence in situ hybridization, and digital image analysis. Am J Clin Pathol. 2005;124(6):854–61.

    Article  Google Scholar 

  21. Randhawa P, Vats A, Shapiro R. Monitoring for polyomavirus BK and JC in urine: comparison of quantitative polymerase chain reaction with urine cytology. Transplantation. 2005;79(8):984–6.

    Article  CAS  Google Scholar 

  22. https://laboratoryinfo.com/types-of-casts-in-urine-and-their-clinical-significance/.

  23. Raab SS, Lenel JC, Cohen MB. Low grade transitional cell carcinoma of the bladder. Cytologic diagnosis by key features as identified by logistic regression analysis. Cancer. 1994;74(5):1621–6.

    Article  CAS  Google Scholar 

  24. Brimo F, Vollmer T, Case B, Aprikian A, Kassouf W, Auger M. Accuracy of urine cytology and the significance of an atypical category. Am J Clin Pathol. 2009;132(5):785–93.

    Article  Google Scholar 

  25. Kannan V, Gupta D. Calculus artifact. A challenge in urinary cytology. Acta Cytol. 1999;43(5):794–800.

    Article  CAS  Google Scholar 

  26. Deshpande V, McKee GT. Analysis of atypical urine cytology in a tertiary care center. Cancer. 2005;105(6):468–75.

    Article  Google Scholar 

  27. Sullivan PS, Chan JB, Levin MR, Rao J. Urine cytology and adjunct markers for detection and surveillance of bladder cancer. Am J Transl Res. 2010;2(4):412–40.

    PubMed  PubMed Central  Google Scholar 

  28. Krishnan B, Truong LD. Prostatic adenocarcinoma diagnosed by urinary cytology. Am J Clin Pathol. 2000;113(1):29–34.

    Article  CAS  Google Scholar 

  29. Tyler KL, Selvaggi SM. Morphologic features of prostatic adenocarcinoma on ThinPrep® urinary cytology. Diagn Cytopathol. 2011;39(2):101–4.

    Article  Google Scholar 

  30. Vandersteen DP, Wiemerslage SJ, Cohen MB. Prostatic duct adenocarcinoma: a cytologic and histologic case report with review of the literature. Diagn Cytopathol. 1997;17(6):480–3.

    Article  CAS  Google Scholar 

  31. Berrettini A, Castagnetti M, Salerno A, Nappo SG, Manzoni G, Rigamonti W, Caione P. Bladder urothelial neoplasms in pediatric age: experience at three tertiary centers. J Pediatr Urol. 2015;11(1):26.e1–5.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Suad Taraif .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Dioufa, N., Prochilo, G., Taraif, S. (2020). Urine Cytology. In: Xu, H., Qian, X., Wang, H. (eds) Practical Cytopathology . Practical Anatomic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-24059-2_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-24059-2_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24058-5

  • Online ISBN: 978-3-030-24059-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics