title: Can cytological features differentiate reactive renal tubular cells from low-grade urothelial carcinoma cells?
abstract: OBJECTIVE
  To compare the cytomorphological and immunocytochemical features of reactive renal tubular cells and low-grade urothelial carcinoma cells (LG-UCs).
  
  
  METHODS
  We examined 15 cytological parameters in 38 cases with reactive renal tubular cells in renal disease and 20 cases of LG-UCs from bladder cancer that had been diagnosed by histological examination. Voided urine cytological parameters evaluated were as follows: (i) maximum cell numbers of clusters, (ii) cannibalism, (iii) rosette-like arrangement, (iv) hobnail-shaped cells, (v) vacuolated cytoplasm, (vi) intracytoplasmic haemosiderin, (vii) irregular nuclear contours, (viii) chromatin pattern, (ix) prominent nucleoli, (x) cast encasement, (xi) casts, (xii) dysmorphic erythrocytes, (xiii) isomorphic erythrocytes, (xiv) necrosis, and (xv) vimentin reactivity. The above parameters were determined using Mann-Whitney U-test and chi-square test, with differences considered significant at P  <  0.05.
  
  
  RESULTS
  In reactive renal tubular cells, low to moderate cell numbers of clusters (fewer than 50 cells), rosette-like arrangement, hobnail-shaped cells, vacuolated cytoplasm, intracytoplasmic haemosiderin, euchromatin pattern, prominent nucleoli, dysmorphic erythrocytes and vimentin reactivity were present in significantly higher proportions compared with those in LG-UCs. In LG-UCs, high cell numbers of clusters (50 cells or more), cannibalism, heterochromatin pattern, isomorphic erythrocytes and necrosis were seen in significantly higher proportions. No significant differences were observed in irregular nuclear contours, cast encasement or casts.
  
  
  CONCLUSIONS
  Based on results of the present study, maximum cell numbers of clusters, cannibalism, rosette-like arrangement, hobnail-shaped cells, vacuolated cytoplasm, intracytoplasmic haemosiderin, chromatin pattern, prominent nucleoli, dysmorphic erythrocytes, isomorphic erythrocytes, necrosis, and vimentin reactivity were capable of distinguishing reactive renal tubular cells from LG-UCs.
authors.affiliation: Laboratory of Pathology, Department of Medical Technology, Kagawa Prefectural College of Health Sciences, Kagawa.
authors.forename: H
authors.initials: H
authors.lastname: Ohsaki
authors.forename: E
authors.initials: E
authors.lastname: Hirakawa
authors.forename: Y
authors.initials: Y
authors.lastname: Kushida
authors.forename: S
authors.initials: S
authors.lastname: Yokoshita
authors.forename: M
authors.initials: M
authors.lastname: Nakamura
authors.forename: H
authors.initials: H
authors.lastname: Kiyomoto
authors.forename: R
authors.initials: R
authors.lastname: Haba
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000175:diagnosis*; D003581:Cytodiagnosis / Q000379:methods; D003937:Diagnosis, Differential; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis*; D007684:Kidney Tubules / Q000473:pathology*; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis*