An International Telecytologic Quiz on Urinary Cytology Reveals Educational Deficits and Absence of a Commonly Used Classification System

Glatz, Katharina; Willi, Niels; Glatz, Dieter; Barascud, Audrey; Grilli, Bruno; Herzog, Michelle; Dalquen, Peter; Feichter, Georg E.; Gasser, Thomas C.; Sulser, Tullio; Bubendorf, Lukas

doi:10.1309/6396-qubu-6hej-bmpl

Cited by 41 publications

(37 citation statements)

References 26 publications

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“…However, this study did not confirm PV positivity with IH and the urinary findings may have been secondary to early urothelial carcinoma. The distinction of BKV infection from urothelial malignancy can be very difficult on cytomorphology alone, as illustrated by a recent study (Glatz et al, 2006) and by case 8 in our series. In a case -control study, Newton et al (2005) found no association between prevalence or titres of anti-BKV antibodies and diagnosis of bladder cancer.…”

Section: Discussionmentioning

confidence: 61%

Polyoma virus infection and urothelial carcinoma of the bladder following renal transplantation

et al. 2008

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Renal transplant recipients are at increased risk of bladder carcinoma. The aetiology is unknown but a polyoma virus (PV), BK virus (BKV), may play a role; urinary reactivation of this virus is common post-renal transplantation and PV large T-antigen (T-Ag) has transforming activity. In this study, we investigate the potential role of BKV in post-transplant urothelial carcinoma by immunostaining tumour tissue for PV T-Ag. There was no positivity for PV T-Ag in urothelial carcinomas from 20 non-transplant patients. Since 1990, 10 transplant recipients in our unit have developed urothelial carcinoma, and tumour tissue was available in eight recipients. Two patients were transplanted since the first case of PV nephropathy (PVN) was diagnosed in our unit in 2000 and both showed PV reactivation post-transplantation. In one of these patients, there was strong nuclear staining for PV T-Ag in tumour cells, with no staining of non-neoplastic urothelium. We conclude that PV infection is not associated with urothelial carcinoma in non-transplant patients, and is uncommon in transplant-associated tumours. Its presence in all tumour cells in one patient transplanted in the PVN era might suggest a possible role in tumorigenesis in that case.

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Section: Discussionmentioning

confidence: 61%

Polyoma virus infection and urothelial carcinoma of the bladder following renal transplantation

et al. 2008

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“…Because they can demonstrate remarkable atypia, cytopathologists who are unfamiliar with this cell type can easily misdiagnose them as malignant urothelial cells. 26,27 Intriguingly, decoy cells are found to be aneuploid by DNA cytometry, further corroborating the false-positive diagnosis. 13 In contrast, none of the 6 samples with decoy cells was found to be positive in FISH analysis with the human DNA probes.…”

Section: Abnormal Fish In Benign Urinary Cytology/tapia Et Almentioning

confidence: 73%

Evaluation of chromosomal aberrations in patients with benign conditions and reactive changes in urinary cytology

Tapia¹,

Glatz²,

Obermann³

et al. 2011

Cancer Cytopathology

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BACKGROUND:Fluorescence in situ hybridization (FISH) is routinely used to help clarify atypical urinary cytology. However, to the authors' knowledge, little is known regarding the frequency of chromosomal aberrations in non‐neoplastic conditions that could potentially lead to false‐positive FISH results. The objective of the current study was to evaluate the frequency of chromosomal aberrations in benign cells of the urinary tract using the UroVysion FISH test.METHODS:The authors analyzed 77 Papanicolaou‐stained benign urine cytology specimens with reactive epithelial atypia using a FISH assay detecting the chromosomes 3, 7, and 17 and the gene locus 9p21. A positive test result was defined as an increased copy number of at least 2 chromosomes in ≥ 4 of 25 cells, or > 10 cells with a tetraploid or octaploid pattern, or homozygous or heterozygous deletion of 9p21 (≥ 12cells).RESULTS:FISH was positive in 27 of 77 bladder washings (35.1%) including 25 of 65 bladder washings (40.5%) and 2 of 15 voided urines (13.5%) from patients with irritative bladder (15 of 36 patients), a history of radiotherapy (7 of 12 patients), nonspecific cystitis (3 of 11 patients), hematuria (3 of 8 patients), and lithiasis (1 of 4 patients) . In 7 of 27 FISH‐positive urothelial specimens, the positivity was solely due a polyploid pattern (tetraploid/octaploid pattern) in > 10 of the cells.CONCLUSIONS:Chromosomal aberrations can occur in reactive urothelial cells, with a tetraploid pattern being the most common. Even an aneuploid pattern of FISH signals does not always prove malignancy because it rarely occurs in reactive urothelial cells. Correlation of FISH results with cytomorphology and patient history is crucial to avoid false‐positive diagnoses. Cancer (Cancer Cytopathol) 2011;. © 2011 American Cancer Society.

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“…This was eloquently demonstrated and documented by Glatz et al [30] via an international telecytology quiz on urinary cytology, where the participants failed to agree even on the proposed categories. The goal of TPS is not only to define morphologic criteria for the various categories in urinary tract cytopathology, but also to standardize the reporting system in order to be universally acceptable and globally utilized.…”

Section: Diagnostic Categories and Morphologic Criteria Of The Paris mentioning

confidence: 90%

The Paris System for Reporting Urinary Cytology: The Quest to Develop a Standardized Terminology

et al. 2016

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The main purpose of urine cytology is to detect high-grade urothelial carcinoma (HGUC). With this principle in mind, The Paris System (TPS) Working Group, composed of cytopathologists, surgical pathologists, and urologists, has proposed and published a standardized reporting system that includes specific diagnostic categories and cytomorphologic criteria for the reliable diagnosis of HGUC. This paper outlines the essential elements of TPS and the process that led to the formation and rationale of the reporting system. The Paris System Working Group, organized at the 2013 International Congress of Cytology, conceived a standardized platform on which to base cytologic interpretation of urine samples. The widespread dissemination of this approach to cytologic examination and reporting of urologic samples and the scheme's universal acceptance by pathologists and urologists is critical for its success. For urologists, understanding the diagnostic criteria, their clinical implications, and the limitations of TPS is essential if they are to utilize urine cytology and noninvasive ancillary tests in a thoughtful and practical manner. This is the first international/inclusive attempt at standardizing urinary cytology. The success of TPS will depend on the pathology and urology communities working collectively to improve this seminal paradigm shift, and optimize the impact on patient care.

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An International Telecytologic Quiz on Urinary Cytology Reveals Educational Deficits and Absence of a Commonly Used Classification System

Cited by 41 publications

References 26 publications

Polyoma virus infection and urothelial carcinoma of the bladder following renal transplantation

Polyoma virus infection and urothelial carcinoma of the bladder following renal transplantation

Evaluation of chromosomal aberrations in patients with benign conditions and reactive changes in urinary cytology

The Paris System for Reporting Urinary Cytology: The Quest to Develop a Standardized Terminology

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