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Primary noninvasive urothelial neoplasms

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


● See also papilloma
● Increased number of urothelial cells with minimal atypia and a small number of red blood cells

Papillary urothelial neoplasm of low malignant potential (PUNLMP)

● See also papillary neoplasm of low malignant potential
● These lesions are cytologically indistinguishable from low grade urothelial carcinomas
● Diagnosis of PUNLMP based only on cytology is not a reproducible diagnosis

Low grade papillary urothelial carcinoma

● See also low grade papillary
● Low sensitivity of urine cytology
● Heterogeneous with small and large clusters of urothelial cells with enlarged nuclei, higher N/C ratio and a small nucleolus
● Cells with a nucleolated globular body and variable slender cytoplasm are suggestive of low grade papillary urothelial carcinoma
● Homogeneous cytoplasm, irregular nuclear membranes and increased N/C ratio are helpful criteria for diagnosis

High grade papillary urothelial carcinomas

● See also high grade papillary
● Clusters and single markedly atypical cells with pleomorphic nuclei, coarse chromatin and prominent nucleoli
● Cells have abundant cytoplasm and may show vacuoles
● Also irregular nuclear contours, coarse chromatin pattern and frequent nucleoli

Urothelial carcinoma in-situ (CIS)

● See also carcinoma in situ
● Cytology is a very important aid in diagnosis of CIS
● Voided specimens from cases with CIS show clusters and single large pleomorphic cells showing marked atypia with hyperchromatic angulated nuclei, coarse chromatin, irregular nuclear contours and occasional prominent nucleoli
● The N/C ratio is high and the cytoplasm is dense
● Differential diagnosis: “decoy” cells (BK virus), degenerated cells, treatment effect: bCG or chemotherapy

End of Bladder > Cytology > Primary noninvasive urothelial neoplasms

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