The Classification of BK (Polyoma) Virus Changes in Urinary Tract Specimens Following Institution of The Paris System for Reporting Urinary Cytology (TPS)

2018 ◽  
Vol 7 (5) ◽  
pp. S43
Author(s):  
Derek Allison ◽  
Morgan Cowan ◽  
Christopher VandenBussche
Keyword(s):  
Urinary Tract ◽  
Polyoma Virus ◽  
Urinary Cytology

scholarly journals Interobserver reproducibility of The Paris System for Reporting Urinary Cytology

CytoJournal ◽  
2017 ◽  
Vol 14 ◽  
pp. 17 ◽  
Author(s):  
Theresa Long ◽  
Lester J. Layfield ◽  
Magda Esebua ◽  
Shellaine R. Frazier ◽  
D. Tamar Giorgadze ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Urinary Cytology ◽  
Low Grade ◽  
High Grade ◽  
Urothelial Cells ◽  
Urothelial Carcinomas ◽  
Absolute Agreement ◽  
Potential Impact ◽  
Urine Specimens

Background: The Paris System for Reporting Urinary Cytology represents a significant improvement in classification of urinary specimens. The system acknowledges the difficulty in cytologically diagnosing low-grade urothelial carcinomas and has developed categories to deal with this issue. The system uses six categories: unsatisfactory, negative for high-grade urothelial carcinoma (NHGUC), atypical urothelial cells, suspicious for high-grade urothelial carcinoma, high-grade urothelial carcinoma, other malignancies and a seventh subcategory (low-grade urothelial neoplasm). Methods: Three hundred and fifty-seven urine specimens were independently reviewed by four cytopathologists unaware of the previous diagnoses. Each cytopathologist rendered a diagnosis according to the Paris System categories. Agreement was assessed using absolute agreement and weighted chance-corrected agreement (kappa). Disagreements were classified as low impact and high impact based on the potential impact of a misclassification on clinical management. Results: The average absolute agreement was 65% with an average expected agreement of 44%. The average chance-corrected agreement (kappa) was 0.32. Nine hundred and ninety-nine of 1902 comparisons between rater pairs were in agreement, but 12% of comparisons differed by two or more categories for the category NHGUC. Approximately 15% of the disagreements were classified as high clinical impact. Conclusions: Our findings indicated that the scheme recommended by the Paris System shows adequate precision for the category NHGUC, but the other categories demonstrated unacceptable interobserver variability. This low level of diagnostic precision may negatively impact the applicability of the Paris System for widespread clinical application.

scholarly journals The Pathology of Tumours of the Urinary Tract

1939 ◽  
Vol 32 (11) ◽  
pp. 1455-1467
Author(s):  
W. D. Newcomb
Keyword(s):  
Urinary Tract ◽  
Connective Tissue ◽  
Renal Pelvis ◽  
Clinical Importance ◽  
Point Of View ◽  
Renal Tubules ◽  
Clear Cut ◽  
Renal Tumours ◽  
The Difference

Attention is called to the difference between the pathologist's and the radiologist's point of view. The reasons for this difference are discussed with special emphasis on renal tumours. Classification of renal tumours. The first main groups are innocent and malignant. Are these really clear-cut or do they blend into one another? The commoner innocent renal tumours are adenoma, fibroma, myoma, lipoma, and angioma. These are rarely of any clinical importance but adenoma is a possible source of hypernephroma. Many elaborate classifications of cancer of the kidney have been proposed but the following four groups are sufficient for most puposes: Carcinoma, hypernephroma, sarcoma, and teratoid tumours. Much the commonest malignant renal tumour in adults is the hypernephroma, thought by Grawitz and others to be derived from ectopic adrenal rests. There is still no agreement concerning their origin but three views are held at the present time: ( a) All are carcinoma of renal tubules. ( b) Some are derived from renal tubules and some from ectopic adrenal. ( c) All are formed from adrenal tissue. These views are discussed with special reference to material in St. Mary's Hospital Museum, and it is suggested that the first view is the most probable although the second cannot be excluded. The teratoid tumours are the commonest in infants and swine. The differences between them and hypernephromata are described. The renal Pelvis, ureter, and bladder all have tumours of the same type and can conveniently be considered together. Connective tissue tumours, both innocent and malignant, are very rare. Papilloma and carcinoma are rare in the pelvis and ureter, but commoner in the bladder. The relation between these two tumours is discussed.

scholarly journals Effect of contrast media on urinary cytopathology specimens

2016 ◽  
Vol 10 (7-8) ◽  
pp. 228 ◽  
Author(s):  
Sebastian Frees ◽  
Samir Bidnur ◽  
Michael Metcalfe ◽  
Peter Raven ◽  
Claudia Chavez-Munoz ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urinary Tract ◽  
Contrast Media ◽  
Contrast Agents ◽  
Urothelial Carcinoma ◽  
Urinary Cytology ◽  
Cancer Model ◽  
Hydropic Degeneration ◽  
Bladder Cell ◽  
Bladder Cancer Model

<p><strong>Introduction:</strong> Urological dogma dictates that washings collected from the urinary tract for cytological assessment must be performed without interference from contrast agents that may alter cellular integrity and diagnostic interpretation. In practice, the initial contrast used to outline the upper tracts is commonly discarded with subsequent saline washings sent for cytology. We hypothesize that contrast washings do not affect the morphology of urothelial carcinoma cells or the integrity of cytology interpretation.</p><p><strong>Methods:</strong> Samples obtained from (1) human bladder cell lines; (2) urine from a human xenograft bladder cancer model using UC-3 cells; and (3) patients with urothelial carcinoma were subjected to various experimental solutions (water, saline, urine, and dilutions of contrast media) for different exposure times. After exposure to various different solutions, samples underwent cytological analysis to assess morphologic and degenerative changes.</p><p><strong>Results:</strong> No cytological differences were seen when cells were exposed to ionic, hyperosmolar, or non-ionic low-osmolar contrast agents for any exposures up to five minutes. Cells exposed to mixtures of contrast agents and urine also demonstrated no evidence of degenerative change. Cells exposed to water for greater than one minute demonstrated significant hydropic degeneration impacting cytological interpretation. At 40 minutes or later, all reagents caused severe degeneration when evaluating urine samples from the mouse bladder cancer model and from patients undergoing urothelial carcinoma.</p><p><strong>Conclusions:</strong> Commonly used contrast agents have no effect on urinary cytology up to five minutes. Contrast washings of the urinary tract should not be discarded and can be sent for cytological diagnosis if fixed within this time period.</p>

scholarly journals Toward an etiological classification of developmental disorders of the kidney and upper urinary tract

2002 ◽  
Vol 61 (1) ◽  
pp. 10-19 ◽  
Author(s):  
Martin Pohl ◽  
Vibha Bhatnagar ◽  
Stanley A. Mendoza ◽  
Sanjay K. Nigam
Keyword(s):  
Urinary Tract ◽  
Developmental Disorders ◽  
Upper Urinary Tract

scholarly journals Practice Patterns in Urinary Cytopathology Prior to the Paris System for Reporting Urinary Cytology

2019 ◽  
Vol 144 (2) ◽  
pp. 172-176 ◽  
Author(s):  
Güliz A. Barkan ◽  
Z. Laura Tabatabai ◽  
Daniel F. I. Kurtycz ◽  
Vijayalakshmi Padmanabhan ◽  
Rhona J. Souers ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Practice Patterns ◽  
Low Frequency ◽  
Daily Practice ◽  
Relevant Information ◽  
Urinary Cytology ◽  
Preparation Methods ◽  
A Cell ◽  
Preparation Techniques ◽  
Urine Specimens

Context.— The Paris System for Reporting Urinary Cytology has been disseminated since its inception in 2013; however, the daily practice patterns of urinary tract cytopathology are not well known. Objective.— To assess urinary tract cytopathology practice patterns across a variety of pathology laboratories to aid in the implementation and future update of the Paris System for Reporting Urinary Cytology. Design.— A questionnaire was designed to gather information about urinary tract cytopathology practices and mailed in July 2014 to 2116 laboratories participating in the College of American Pathologists interlaboratory comparison program. The participating laboratories' answers were summarized. Results.— Of the 879 of 2116 laboratories (41%) that participated, 745 (84.8%) reported processing urinary tract specimens in house. The laboratories reported processing various specimen types: voided urine, 735 of 738 (99.6%); bladder washing/barbotage, 639 of 738 (86.6%); and catheterized urine specimens, 653 of 738 (88.5%). Some laboratories used multiple preparation methods, but the most commonly used preparation techniques for urinary tract specimens were ThinPrep (57.4%) and Cytospin (45.5%). Eighty-eight of 197 laboratories (44.7%) reported preparing a cell block, but with a low frequency. Adequacy criteria were used by 295 of 707 laboratories (41.7%) for voided urine, and 244 of 707 (34.5%) assessed adequacy for bladder washing/barbotage. More than 95% of the laboratories reported the use of general categories: negative, atypical, suspicious, and positive. Polyomavirus was classified as negative in 408 of 642 laboratories (63.6%) and atypical in 189 of 642 (29.4%). One hundred twenty-eight of 708 laboratories (18.1%) performed ancillary testing, and of these, 102 of 122 (83.6%) reported performing UroVysion. Conclusions.— Most laboratories use the ThinPrep method followed by the Cytospin technique; therefore, the criteria published in The Paris System for Reporting Urinary Cytology, based mostly on ThinPrep and SurePath, should be validated for Cytospin, and relevant information should be included in the revised edition of The Paris System for Reporting Urinary Cytology.

Significance of Urinary Cytology in the Early Detection of Transitional Cell Cancer of the Upper Urinary Tract

1976 ◽  
Vol 116 (6) ◽  
pp. 781-783 ◽  
Author(s):  
Horst Zincke ◽  
Juan J. Aguilo ◽  
George M. Farrow ◽  
David C. Utz ◽  
Ansar U. Khan
Keyword(s):  
Urinary Tract ◽  
Early Detection ◽  
Cell Cancer ◽  
Transitional Cell ◽  
Upper Urinary Tract ◽  
Urinary Cytology ◽  
Transitional Cell Cancer

scholarly journals Impact of Initial Computed Tomography Findings on Management of Atypical Urinary Cytology of the Upper Urinary Tract

2021 ◽  
pp. 1-5
Author(s):  
Kotaro Takemura ◽  
Taketo Kawai ◽  
Yusuke Sato ◽  
Jimpei Miyakawa ◽  
Satoru Taguchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Urinary Tract ◽  
Upper Urinary Tract ◽  
Wall Thickening ◽  
Urinary Cytology ◽  
Class Iii ◽  
Ct Findings ◽  
Retrograde Ureteropyelography ◽  
Tumor Like Lesions

<b><i>Introduction:</i></b> Management of patients with atypical urinary cytology (class III) of the upper urinary tract is often complicated because some patients develop upper urinary tract urothelial carcinoma (UTUC). Here, we aimed to help define the optimal management of these patients. <b><i>Methods:</i></b> We investigated 31 patients who underwent retrograde ureteropyelography (RP) and were diagnosed with atypical findings of upper urinary tract cytology. <b><i>Results:</i></b> UTUC was revealed in 17 of 31 patients during the follow-up period of 1 year or longer. Tumor-like lesions and wall thickening in the upper urinary tract on initial computed tomography (CT) were significant predictors of UTUC (<i>p</i> = 0.0002 and <i>p</i> = 0.012, respectively). All 11 patients with tumor-like lesions and 3 of 8 patients with wall thickening on initial CT underwent nephroureterectomy, and UTUC was confirmed histologically. Moreover, 3 of 12 patients with hydronephrosis only or with normal findings later went on to develop UTUC. Repeated RP performed within 6 months from the initial RP was able to distinguish patients with UTUC from those without, even in individuals with normal CT findings. <b><i>Discussion/Conclusion:</i></b> Repeated RP based on initial CT findings is recommended in patients with atypical urinary cytology of the upper urinary tract. Nephroureterectomy without repeated RP may be warranted in patients with tumor-like lesions on initial CT findings.

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