1 / 14

1 Urine Cytology

1 Urine Cytology. Soheir Mahfouz 2017. NORMAL CELLS. LOW Cellularity Single cells Clear background. NORMAL SMEAR. 1- PATTERN OF EXFOLIATION ( LOW CELLULARITY clean)

brianajones
Download Presentation

1 Urine Cytology

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. 1 Urine Cytology Soheir Mahfouz 2017

  2. NORMAL CELLS Soheir Mahfouz -Self Study Series

  3. LOW Cellularity Single cells Clear background NORMAL SMEAR 1- PATTERN OF EXFOLIATION (LOW CELLULARITY clean) Single cell exfoliation: Mainly urothelial cells in small numbers. The number depends on the method. More cells in cystoscopic samples, bladder washing or after exercise In groups: Usually seen after catheterization or after cystoscopy 2-CELL TYPES • Urothelial cells • Superficial /umbrella cells • Intermediate • Deep cells • Squamous cells: exfoliate from distal urethra in male or are vulvo-vaginal in females. They may also exfoliate in the presence of stones-parasites-trichomonas • Prostatic cells & Seminal vesicle cells : rare except after prostatic massage • Renal cells: rare • WBC should be less than 5/HPF if more consider urinary tract inflammation & RBCs should be less than 1/several HPF Soheir Mahfouz -Self Study Series

  4. NB : A-crystals: normally should not be present B-casts: important in the follow up of renal transplants for rejection/ indicate renal disease • Hyaline: acceptable 1 or 2 in a smear*. They are pale blue homogenous, well defined & cylindrical transparent, may have orange colour if increased it means excess protein filtration in nephrotic / nephritic syndromes • Cellular/epithelial: normal none or 1/10 HPF, they are desquamated cell + protein. If they contain fat patient is diabetic • Granular casts may be found after strenuous exercise otherwise pathologic NB: if the casts are wide in caliber (tubular dilatation ) bad sign. • WBC: with sharp contours, indicates: pyelonephritis • RBC casts: normally not present They indicate hemorrhagiccondition in kidneys: AGN- polyarteritisnodosa-crush syndrome, hepatorenal A.Graft rejection NB: Pseudocasts are trapped WBC with irregular contour and originate from lower urinary tract infection C-Fungus(alternaria)-vorticells (protozoa of fresh water) – parasites- organisms in water or plant material pollen Soheir Mahfouz -Self Study Series

  5. Candida Ova in a pseudocast Renal cast Corpora amylacea HPV Alternaria Polyoma virus Soheir Mahfouz -Self Study Series

  6. Normal urothelial cells 1) Umbrella cells (largest) 2) Intermediate cells, 3) Basal cells (smallest). Conspicuous nucleoli are only seen in intermediate and basal urothelial cells, in bladder washings. The nuclear membranes are smooth and the cells have abundant vacuolated(bubbly) cytoplasm. 4)+/- a benign columnar cell, from the bladder dome or trigone. Soheir Mahfouz -Self Study Series

  7. Soheir Mahfouz -Self Study Series

  8. Umbrella cells Normal umbrella cells. Surface urothelial cells covering the underlying cells • Abundantpear shaped cytoplasm and low N/C ratio. • Thickened outer cytoplasmic margins ("saucer cup edge") and vacuolatedperinuclear areas. • nuclei are uniform in size and central- bi & multinucleation common Soheir Mahfouz -Self Study Series

  9. Umbrella cells Soheir Mahfouz -Self Study Series

  10. Reactive cells Soheir Mahfouz -Self Study Series

  11. Reactive cells • Reactive urothelial cells with distinctive nucleoli and multiple cytoplasmic vacuoles N.B • Use the lymphocyte and squamous cell for size comparisons. • Sheets are monolayer DD TCC umbrella squamous Soheir Mahfouz -Self Study Series

  12. Dysplasia (UIN) • NB: ALL KERATINIZING dysplasia are considered high grade / CIS Sheets monolayer - no nucleolus- No mass Dysplasia may be seen in both transitional & squamous epithelial cells: The cells show irregularity in shape & size of nuclei. There is noticeable irregularity of chromatin density & pattern - Mild dysplasia / low grade UIN is insignificant clinically - Severe dysplasia requires cystoscopic biopsy and follow up DD TCC - CIS : Single cell exfoliation- NO MASS – No tumour diathesis-NO nucleolus ( DD HG TCC) Soheir Mahfouz -Self Study Series

  13. Metaplastic cells Metaplastic smears ARE GENERALLY CELLULAR ONES displaying inflammatory changes A) Squamous cells: 1-cytoplasm pink –orange with double contour 2-Nucleus may be vesicular ( mature metaplasia) B) Columnar cells: uniform cells with basal nuclei Soheir Mahfouz -Self Study Series

  14. Columnar metaplasia & UIN Soheir Mahfouz -Self Study Series

More Related