title: Micropapillary variant of transitional cell carcinoma of the urinary bladder: a report of three cases with cytologic diagnosis in urine specimens.
abstract: BACKGROUND
  Micropapillary transitional cell carcinoma is a recently described, aggressive variant of bladder cancer. Its cytologic features in urine have not been previously characterized.
  
  
  METHODS
  Three cases illustrate the urinary cytologic features of this high grade urothelial carcinoma and its concurrent biopsy findings. This tumor is similar to low. grade urothelial lesions of the bladder, tends to present as micropapillary clusters in urine and yet has high grade nuclear features within these clusters that help with the differential diagnosis of a flat, high grade urothelial carcinoma.
  
  
  CONCLUSIONS
  The micropapillary type of transitional cell carcinoma is a distinct morphologic entity with an aggressive clinical course. Recognizing its presence in urinary cytology, albeit a rare occurrence, is important in distinguishing this lesion from the more indolent, low grade papillary lesions and high grade urothelial carcinomas, which continuously shed single malignant urothelial cells.
authors.affiliation: Cytopathology Section, Barnes-Jewish Hospital, Washington University Medical Center, St Louis, Missouri 63118, USA.
authors.forename: L R
authors.initials: LR
authors.lastname: Ylagan
authors.forename: P A
authors.initials: PA
authors.lastname: Humphrey
mesh_terms: D000368:Aged; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000473:pathology* / Q000652:urine; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000473:pathology* / Q000652:urine; D006801:Humans; D008297:Male; D008875:Middle Aged; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000652:urine; D014556:Urine / Q000166:cytology*