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Format of diagnostic report

Reviewer: Rugvedita Parakh, M.D. (see Reviewers page)
Revised: 9 February 2013, last major update May 2010
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

Recommendations for Diagnostic Format and Categories for Urinary Cytology Specimens
Papanicolaou Society of Cytopathology Practice Guidelines Task Force

I. Adequacy Statement (Optional)

● Satisfactory for evaluation
● List any quality factors affecting specimen
● Unsatisfactory for evaluation (give reason)

II. General Categorization

● Negative for epithelial cell abnormality (see Descriptive Diagnoses)
● Epithelial cell abnormality present (see Descriptive diagnosis)

III. Descriptive Diagnosis

● Negative for epithelial cell abnormality
● Infectious agents
● Bacterial organisms
● Fungal organisms
● Viral changes (CMV, herpes, adenovirus, polyomavirus)
● Nonspecific inflammatory changes
● Acute inflammation
● Chronic inflammation
● Changes consistent with xanthogranulomatous pyelonephritis
● Cellular changes associated with:
  Chemotherapeutic agents
● Epithelial Cell Abnormalities
  Atypical urothelial cells (*see comment)
  Low-grade urothelial carcinoma
  High-grade urothelial carcinoma (invasive carcinoma vs. carcinoma in situ)
  Squamous cell carcinoma
  Other malignant neoplasms (specify type)

IV. Other

● An optional comment section should be used to list additional findings or further clarification of findings

Additional references

Diagn Cytopathol 2004;30:24

End of Bladder > Cytology > Format of diagnostic report

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