Bladder, ureter & renal pelvis
Cytology-nonneoplastic lesions

Topic Completed: 1 February 2013

Minor changes: 25 August 2020

Copyright: 2003-2020,, Inc.

Rugvedita Parakh, M.D.
Page views in 2019: 563
Page views in 2020 to date: 473
Table of Contents
Definition / general
Cite this page: Parakh R Cytology-nonneoplastic lesions. website. Accessed September 24th, 2020.
Definition / general
Infection / bacterial cystitis
  • See also acute cystitis
  • Women in the reproductive age group
  • Abundant neutrophils, few enlarged urothelial cells with vacuolated cytoplasm; N/C ratio is maintained with fine chromatin pattern of nuclei; also urothelial cells with degenerative changes

Human Polyomavirus infection
  • See also BK virus
  • Due to reactivation of infection in immunosuppressed states; e.g. chemotherapy, diabetes, organ transplantation or AIDS
  • Single dense basophilic homogeneous intra-nuclear inclusions, pale nuclear inclusions creating a homogeneous space or clearing of the nuclei with a network of chromatin filaments
  • "Decoyā€¯ cells: nuclear hyperchromasia mimicking carcinoma cells; polyomavirus infected cells show filaments of chromatin

  • See also schistosomiasis
  • Trichomonas vaginalis, Schistosoma hematobium and Filariasis
  • Schistosoma hematobium: most common in Egypt and elsewhere in Africa; abundant squamous cells and anucleated squames due to squamous metaplasia induced by the infection
  • Bladder infection by Schistosoma hematobium is strongly associated with squamous cell carcinoma

Lithiasis (stones)
  • Increased cellularity
  • Urothelial cell clusters with or without cellular atypia
  • Hyperchromasia and prominent nucleoli
  • Differential diagnosis includes a low grade papillary lesion; clinical history is paramount in interpreting these specimens

  • See also malakoplakia
  • Middle aged women
  • Histiocytes with eosinophilic cytoplasm containing basophilic inclusions that are PAS+; also calcium and iron positive concentric laminations (Michaelis-Guttmann bodies)
  • Background of granular debris
  • Urothelial cells display reactive changes

Vesico-enteric fistula
  • Due to colon cancer, diverticulitis, inflammatory bowel disease, radiation therapy or surgery
  • Urine contains fecal material including vegetable cells or degenerated striated cells associated with amorphous debris and bacilli

Cystitis glandularis /cystitis cystica
  • See also cystitis cystica / glandularis
  • A few cohesive groups of bland columnar cells are present, which are occasionally associated with goblet cells
  • Clean background
  • Differential diagnosis includes adenocarcinoma; dirty background and nuclear atypia with coarse chromatin, pleomorphism and nucleoli

Squamous metaplasia
  • See also squamous metaplasia
  • Premenopausal women
  • The presence of keratinized epithelium, particularly with atypia, warrants further evaluation

Nephrogenic adenoma
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