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Bladder

Cytology

Cytology - normal findings

Reviewer: Rugvedita Parakh, M.D. (see Reviewers page)
Revised: 13 February 2013, last major update April 2011
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

Voided urine
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● Paucicellular
● 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

Umbrella cells	Urothelial cells	Urothelial cells
Superficial cells (arrows) retain their shape; much larger (with larger nuclei) than intermediate and basal cells

Instrumentation related urine
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● 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
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● 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 > Cytology - normal findings

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