High-Grade Urothelial Carcinoma on Urine Cytology Resembling Umbrella Cells.

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High-Grade Urothelial Carcinoma on Urine Cytology Resembling Umbrella Cells.

Acta Cytol. 2018;62(1):62-67

Authors: Renshaw AA, Gould EW

Abstract
CONTEXT: High-grade urothelial carcinoma (UC) cells have many appearances on urine cytology, but according to The Paris System, they can be easily distinguished from umbrella cells.
OBJECTIVE: We aimed to define the incidence and appearance of high-grade UC cells that resemble umbrella cells in Cytospin preparations on urine cytology.
RESULTS: Cytospin preparations from 331 cases with biopsy follow-up (230 benign/low-grade and 101 malignant [22 carcinoma in situ, 52 papillary, 19 invasive UC, 8 other] cases) were reviewed. A total of 18 cases with malignant cells resembling umbrella cells were identified (17.8% of the malignant cases) and were the only type of malignant cell in 3% of the cases. Two patterns were identified. Tumor cells were either identifiable by at least 20 abnormal cells which were large, had abundant cytoplasm but an elevated nuclear-to-cytoplasmic ratio, and markedly enlarged, round-to-elongated nucleoli, or else rare cells with abundant cytoplasm but obviously malignant nuclei. Cells without nucleoli or obviously malignant nuclei were not specific.
CONCLUSIONS: Malignant cells resembling umbrella cells can be seen in up to 17% of urine cytology specimens.

PMID: 29130942 [PubMed - indexed for MEDLINE]

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