Urine cytology

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The Paris System for reporting urine cytology, version 2.0, ranging from negative to positive for high grade urothelial carcinoma. The Paris System for reporting urinary cytology 2.0.png
The Paris System for reporting urine cytology, version 2.0, ranging from negative to positive for high grade urothelial carcinoma.

Urine cytology is a test that looks for abnormal cells in urine under a microscope. The test commonly checks for infection, inflammatory disease of the urinary tract, cancer, or precancerous conditions. It can be part of a broader urinalysis. If a cancerous condition is detected, other tests and procedures are usually recommended to diagnose cancers, including bladder cancer, ureteral cancer and cancer of the urethra. It is especially recommended when blood in the urine (hematuria) has been detected.

Urine typically contains epithelial cells shed from the urinary tract, and urine cytology evaluates this urinary sediment for the presence of cancerous cells [2] [3] from the lining of the urinary tract, and it is a convenient noninvasive technique for follow-up analysis of patients treated for urinary tract cancers.

For this process, urine must be collected in a reliable fashion, and if urine samples are inadequate, the urinary tract can be assessed via instrumentation, such as a catheter. In urine cytology, collected urine is examined microscopically.

One limitation, however, is the inability to definitively identify low-grade cancer cells and urine cytology is used mostly to identify high-grade tumors. [4]

If the test detects atypical or cancerous cells, further tests may be recommended, such as cystoscopy and a CT scan.

See also

Related Research Articles

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<span class="mw-page-title-main">Cystoscopy</span> Medical procedure; endoscopy of the urinary bladder via the urethra

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<span class="mw-page-title-main">Cytopathology</span> A branch of pathology that studies and diagnoses diseases on the cellular level

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<span class="mw-page-title-main">Urinalysis</span> Array of tests performed on urine

Urinalysis, a portmanteau of the words urine and analysis, is a panel of medical tests that includes physical (macroscopic) examination of the urine, chemical evaluation using urine test strips, and microscopic examination. Macroscopic examination targets parameters such as color, clarity, odor, and specific gravity; urine test strips measure chemical properties such as pH, glucose concentration, and protein levels; and microscopy is performed to identify elements such as cells, urinary casts, crystals, and organisms.

<span class="mw-page-title-main">Hematuria</span> Medical condition

Hematuria or haematuria is defined as the presence of blood or red blood cells in the urine. "Gross hematuria" occurs when urine appears red, brown, or tea-colored due to the presence of blood. Hematuria may also be subtle and only detectable with a microscope or laboratory test. Blood that enters and mixes with the urine can come from any location within the urinary system, including the kidney, ureter, urinary bladder, urethra, and in men, the prostate. Common causes of hematuria include urinary tract infection (UTI), kidney stones, viral illness, trauma, bladder cancer, and exercise. These causes are grouped into glomerular and non-glomerular causes, depending on the involvement of the glomerulus of the kidney. But not all red urine is hematuria. Other substances such as certain medications and foods can cause urine to appear red. Menstruation in women may also cause the appearance of hematuria and may result in a positive urine dipstick test for hematuria. A urine dipstick test may also give an incorrect positive result for hematuria if there are other substances in the urine such as myoglobin, a protein excreted into urine during rhabdomyolysis. A positive urine dipstick test should be confirmed with microscopy, where hematuria is defined by three or more red blood cells per high power field. When hematuria is detected, a thorough history and physical examination with appropriate further evaluation can help determine the underlying cause.

<span class="mw-page-title-main">Urine test</span> Medical test of urine

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<span class="mw-page-title-main">Transitional cell carcinoma</span> Medical condition

Transitional cell carcinoma, also called urothelial carcinoma, is a type of cancer that typically occurs in the urinary system. It is the most common type of bladder cancer and cancer of the ureter, urethra, and urachus. Symptoms of urothelial carcinoma in the bladder include hematuria. Diagnosis includes urine analysis and imaging of the urinary tract (cystoscopy). Transitional cell carcinomas arise from the transitional epithelium, a tissue lining the inner surface of these hollow organs. When the term "urothelial" is used, it specifically refers to a carcinoma of the urothelium, meaning a transitional cell carcinomas of the urinary system.

Urologic diseases or conditions include urinary tract infections, kidney stones, bladder control problems, and prostate problems, among others. Some urologic conditions do not affect a person for that long and some are lifetime conditions. Kidney diseases are normally investigated and treated by nephrologists, while the specialty of urology deals with problems in the other organs. Gynecologists may deal with problems of incontinence in women.

Lobular carcinoma <i>in situ</i> Medical condition

Lobular carcinoma in situ (LCIS) is an incidental microscopic finding with characteristic cellular morphology and multifocal tissue patterns. The condition is a laboratory diagnosis and refers to unusual cells in the lobules of the breast. The lobules and acini of the terminal duct-lobular unit (TDLU), the basic functional unit of the breast, may become distorted and undergo expansion due to the abnormal proliferation of cells comprising the structure. These changes represent a spectrum of atypical epithelial lesions that are broadly referred to as lobular neoplasia (LN).

The Bethesda system (TBS), officially called The Bethesda System for Reporting Cervical Cytology, is a system for reporting cervical or vaginal cytologic diagnoses, used for reporting Pap smear results. It was introduced in 1988 and revised in 1991, 2001, and 2014. The name comes from the location of the conference, sponsored by the National Institutes of Health, that established the system.

<span class="mw-page-title-main">Urine test strip</span> Diagnostic tool used in urinalysis

A urine test strip or dipstick is a basic diagnostic tool used to determine pathological changes in a patient's urine in standard urinalysis.

<span class="mw-page-title-main">Papillary urothelial neoplasm of low malignant potential</span> Medical condition

Papillary urothelial neoplasm of low malignant potential (PUNLMP) is an exophytic, (microscopically) nipple-shaped pre-malignant growth of the lining of the upper genitourinary tract, which includes the renal pelvis, ureters, urinary bladder and part of the urethra.

<span class="mw-page-title-main">Cystitis glandularis</span>

Cystitis glandularis is the transformation of mucosal cells lining the urinary bladder. They undergo glandular metaplasia, a process in which irritated tissues take on a different form, in this case that of a gland. The main importance is in the findings of test results, in this case histopathology. They must distinguish a benign metaplastic change from the cancerous condition urothelial cell carcinoma. It is a very common finding in bladder biopsies and cystectomies, and most often found in the trigone area. Cystitis glandularis lesions are usually present as small microscopic foci; however, occasionally it can form raised intramucosal or polypoid lesions. The cystitis glandularis lesions are within the submucosa.

<span class="mw-page-title-main">Ureteral cancer</span> Medical condition

Ureteral cancer is cancer of the ureters, muscular tubes that propel urine from the kidneys to the urinary bladder. It is also known as ureter cancer, renal pelvic cancer, and rarely ureteric cancer or uretal cancer. Cancer in this location is rare. Ureteral cancer becomes more likely in older adults, usually ages 70–80, who have previously been diagnosed with bladder cancer.

<span class="mw-page-title-main">Invasive urothelial carcinoma</span> Medical condition

Invasive urothelial carcinoma is a type of transitional cell carcinoma. It is a type of cancer that develops in the urinary system: the kidney, urinary bladder, and accessory organs. Transitional cell carcinoma is the most common type of bladder cancer and cancer of the ureter, urethra, renal pelvis, the ureters, the bladder, and parts of the urethra and urachus. It originates from tissue lining the inner surface of these hollow organs - transitional epithelium. The invading tumors can extend from the kidney collecting system to the bladder.

References

  1. Image by Mikael Häggström. Reference: Wojcik, EM; Kurtycz, DFI; Rosenthal, DL (2022). "We'll always have Paris – The Paris System for Reporting Urinary Cytology 2022". Journal of the American Society of Cytopathology. 11 (2): 62–66. doi:10.1016/j.jasc.2021.12.003. PMID   35094954. S2CID   246429500.
  2. "Urine cytology - Mayo Clinic". www.mayoclinic.org. Retrieved 2019-02-27.
  3. Eskra, Jillian N.; Rabizadeh, Daniel; Zhang, Jiayi; Isaacs, William B.; Luo, Jun; Pavlovich, Christian P. (July 2021). "Specific Detection of Prostate Cancer Cells in Urine by RNA In Situ Hybridization". Journal of Urology. 206 (1): 37–43. doi:10.1097/JU.0000000000001691. ISSN   0022-5347.
  4. Auger, Manon; Kassouf, Wassim; Aprikian, Armen; Case, Bruce; Vollmer, Robin T.; Brimo, Fadi (2009-11-01). "Accuracy of Urine Cytology and the Significance of an Atypical Category". American Journal of Clinical Pathology. 132 (5): 785–793. doi: 10.1309/AJCPPRZLG9KT9AXL . ISSN   0002-9173. PMID   19846822.
  5. Wang Y, Auger M, Kanber Y, Caglar D, Brimo F (2018). "Implementing The Paris System for Reporting Urinary Cytology results in a decrease in the rate of the "atypical" category and an increase in its prediction of subsequent high-grade urothelial carcinoma". Cancer Cytopathol. 126 (3): 207–214. doi:10.1002/cncy.21958. PMID   29278461. S2CID   3936852.