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[283] Urothelial Carcinoma with Associated Proliferative Cystitis: Analyses of ThinPrep Urine Cytology and Fluorescence In Situ Hybridization

Y Chen, S Koya, PM Houser, RS Hoda. Medical University of South Carolina, Charleston, SC; University of Alabama at Birmingham, Montgomery, AL

Background: Proliferative cystitis (PC), including cytsitis cystica and cystitis glandularis, is a benign reactive urothelial process, and is generally considered to be a diagnostic pitfall in urinary cytology.
Design: All histologically-proven cases of PC with and without urothelial carcinoma (UCA) with urine cytology specimens (UCS) and with fluorescence in situ hybrizidization [FISH (UroVysion, Vysis Inc., Dovers Grove, IL)] were reviewed (2000-6). Papanicolaou-stained ThinPrep (TP) were used for UCS. Appropriate controls were used for FISH.
Results: Clinicopathological material from 16/5700 (0.26%) UCS from 16 patients with PC+FISH (8) and PC+UCA+FISH (8) were reviewed. Eight UCA cases included 5 high-grade UCA (all invasive) and 3 low-grade UCA. Please see Table 1 for data on correlation of UCS and FISH

Table 1
Positive urinary cytologyPositive FISH
PC2/8 (25%)3/8 (37.5%)
PC+UC5/8 (62.5%)4/8 (50%)
Atypical included as positive in urinary cytology

Upon review of TP slides, UCS with PC were moderately cellular and demonstrated three-dimensional clusters of benign-appearing urothelial cells with slightly enlarged pale nuclei and small nucleoli. There were two false-positive cases (both diagnosed as atypical). Both cases were considered cytologic overcalls upon review. PC+UCA (high-grade) were hypercellular with clusters and single malignant cells. Nuclei were hyperchromatic and irregular. Nucleus to cytoplasmic ratio was high. There were three false-negative cases, all low-grade UCA. Upon review no malignant cells were seen in these UCS. Overall sensitivity and specificity of TP UCS was 62.5% and 75% and for was FISH 50% and 62.5% respectively.
Conclusions: PC does not pose a diagnostic pitfall in urinary cytology, 75% of PC cases were accurately identified. Role of FISH in cases of PC (with and without UCA) needs further study.
Category: Cytopathology

Tuesday, March 27, 2007

Poster # 30, Tuesday Afternoon

 

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