[Cytology of the urinary tract: Between uncertainty and clarity].
Reliable detection of poorly differentiated urothelial carcinoma and the detection of carcinoma in situ, which is often invisible by cystoscopy, are the undisputed strength of urinary cytology. In contrast, well-differentiated urothelial tumors are often missed by cytology. We suggest the following classification: negative, questionable, suspicious, and positive. Due to the complex clinico-pathological associations, the classification should always be accompanied by an appropriate commentary. The WHO 2004 classification separates the clinically less important low-grade tumors from the clinically relevant high-grade tumors, usually classified as "positive" by cytology. A cytological diagnosis of low-grade tumors by cytology is of minor clinical importance. Most urothelial neoplasias are characterized by chromosomal aberrations. This makes multi-target fluorescence in situ hybridization (FISH) assay suitable for the clarification of non-definitive cytology. In contrast, positive cytology does not need further confirmation by FISH analysis. Standardized diagnosis and the possibility for supplementary analyses increase the diagnostic value of urinary cytology.
Bubendorf
L
L
Institut für Pathologie, Universitätsspital Basel, Schönbeinstr 40, 4003 Basel, Schweiz. lbubendorf@uhbs.ch
Dalquen
P
P
Savic
S
S
D002278:Carcinoma in Situ / Q000235:genetics / Q000473:pathology*; D002295:Carcinoma, Transitional Cell / Q000235:genetics / Q000473:pathology*; D002869:Chromosome Aberrations; D003558:Cystoscopy; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D009361:Neoplasm Invasiveness / Q000473:pathology; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000235:genetics / Q000473:pathology*; D014556:Urine / Q000166:cytology