Cytomorphological characteristics of low‐grade papillary urothelial carcinoma for differential diagnosis from benign papillary urothelial lesions: logistic regression analysis in SurePath^™ liquid‐based voided urine cytology

Abstract

The distinctive cytological criteria identified above may prove to be helpful in cases in which other conventional criteria for LGPUC are insufficient for diagnosis.

The cytomorphological features of low‐grade urothelial neoplasms vary by specimen type

“…Although previous morphologic studies examined only VU or UW specimens, the current study included all urine specimen types and allowed us to compare features between them. Raab et al found that specimen type appears to impact the predictive value of urine cytology, with VU samples being more specific and slightly less sensitive than IU specimens.…”

“…25 Furthermore, they stated that features such as nuclear enlargement, hyperchromasia, and nuclear membrane irregularity are less reliable for diagnosis in SurePath preparations given the tendency for cellular/nuclear shrinkage and higher rates of hyperchromasia and nuclear membrane irregularity compared with conventional smears. 25 The current study did not include a cohort of specimens with atypical cytological diagnoses and benign histology on follow-up; we focused on comparing subgroups within urine specimens with LGUN on follow-up. With regard to the aforementioned features identified, we found that UW specimens contained significantly more cytoplasmic tails (eg, comet cells) and enlarged nuclei >4 times the size of a neutrophil when compared with VU specimens.…”

“…Although the preparation methodology varies from study to study, Chung et al recently performed what to the best of our knowledge was the first study with UT samples prepared using the SurePath system to evaluate cytological features that were more prevalent in VU samples with LGUN versus benign histology on follow‐up. It is interesting to note that only cases containing papillaroid clusters on the slides were selected.…”

“…The authors identified 7 cytological findings that reached statistical significance in predicting LGUN (loss of polarity in papillaroid clusters, irregular contours of these clusters, loss of cytoplasmic vacuoles, presence of comet cells, absence of columnar cells, hobnail features, and hyperchromasia) . Furthermore, they stated that features such as nuclear enlargement, hyperchromasia, and nuclear membrane irregularity are less reliable for diagnosis in SurePath preparations given the tendency for cellular/nuclear shrinkage and higher rates of hyperchromasia and nuclear membrane irregularity compared with conventional smears . The current study did not include a cohort of specimens with atypical cytological diagnoses and benign histology on follow‐up; we focused on comparing subgroups within urine specimens with LGUN on follow‐up.…”

Liquid-Based Cytology Features of Papillary Squamotransitional Cell Carcinoma of the Uterine Cervix

“…Although papillary architecture may be seen in HSILs, the papillary fragments of PSTCC have been described to show more complex arborizing patterns [4]. In addition, the presence of horizontally aligned cells on the surface of papillary structures—similar to that seen in LGPUC in urine cytology—has been shown to be a characteristic cytological feature of PSTCC [4,8].…”