Bladder - Cytology

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Bladder

Cytology

Normal findings

Reviewer: Dr. Rugvedita Parakh, Cedars-Sinai Medical Center

Revised: 30 May 2010, last major update May 2010

Voided urine

● Paucicellular

● Urothelial cells, urothelial cells, squamous cells, inflammatory cells and possibly red blood cells

● The umbrella cells have one nucleus, abundant delicate cytoplasm, low N/C ratio, smooth nuclear contours with fine chromatin pattern and a small chromocenter

● The basal and intermediate layers are smaller and have a columnar or cuboidal appearance; the nuclei are round with smooth nuclear contours with a fine chromatin pattern

● Nucleoli are either absent or single and minute

● Reactive conditions (e.g. urolithiasis, post instrumentation) demonstrate clusters of basal and intermediate urothelial cells

http://www.pathologyoutlines.com/images/kidney/2_03.jpg

Umbrella cells Urothelial cells #1 #2

Superficial cells (arrows) retain their shape.

They are much larger with larger nuclei than

Intermediate and basal cells.

Instrumentation related urine

● More cellular

● Presence of clusters of urothelial cells forming cell balls and pseudopapillary clusters

● The urothelial cells have a low N/C ratio, round nuclei, fine chromatin pattern and smooth nuclear contours

● Instrumentation effect: crowded cluster formations, hyperchromasia and distinct nucleoli; may lead to a false positive diagnosis

Ileal conduit urine

● Cellular

● Many degenerated single cells (oval with pyknotic nuclei) and few glandular cells (vacuolated cytoplasm, hyperchromatic nuclei but preserved N/C ratio of normal cells)

● Dirty background

● Non-specific eosinophilic cytoplasmic inclusions

● A potential pitfall due to hyperchromasia

Degenerated cells and debris

End of Bladder > Cytology > Normal findings

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