Urine Cytology

Edi Wibowo
 1st reported by Papanicollaou and Marshall (1945)

Microscopic evaluation of morphologic features of

shed urothelial cells

to detect high-grade urothelial carcinoma (HGUC)

to detect high-grade urothelial carcinoma (HGUC)

Sensitivity & Specificity in HGUC (38-84%), in LGUC

(20-53%)
Barkan GA, et al. The Paris System for Reporting Urinary Cytology: The Quest to Develop a Standardized Terminology. Acta
Cytologica. Jun 2016.60:185–97.
Tan WS, et al. Does urinary cytology have a role in haematuria investigations. BJU Int. Jul 2018. 1-19.
 Indication

• Screening test for urothelial malignancies, especially

in people with occupational exposure to carcinogens.
• Evaluation of patients presenting with hematuria.
• To monitor patients of urothelial neoplasms post
treatment.
• To detect infection especially of polyoma virus in
patients who have undergone renal transplantation.

Bhat A, Manjunath J, Manjunath S. Urine Cytology a Review. Annals of Applied Bio-Sciences .

2016.3(1):6-10.
 Methods

Voided urine Catheterized urine Direct Sampling

Bladder Retrograde
washing or catheterization Direct Brushing
barbotage of ureters
Koss LG, Hoda RS. 2012. Chapter 2 Indication, Collection, and Laboratory Processing of Cytologic
Samples. Koss’s Cytology of the Urinary Tract with Histopathologic Correlations. Springer.7-
16.
 Reporting Systems by G. Papanicolaou
• Class 1- Absence of abnormal or atypical cells
• Class 2- Atypical cells present but without abnormal
features
• Class 3- Cells with abnormal features but not
sufficiently pathognomonic
• Class 4- Fair number of pathognomonic cells and
cell clusters
• Class 5- Large number of conclusive cells and cell
clusters
Bhat A, Manjunath J, Manjunath S. Urine Cytology a Review. Annals of Applied Bio-Sciences .
2016.3(1):6-10.
 • The positive predictive value was 94.8% for positive
cytology (Class 4 or 5)
• 47.4% for suspicious cytology (Class 3)
• 7.4% for negative cytology (Class 1 or 2)

Bhat A, Manjunath J, Manjunath S. Urine Cytology a Review. Annals of Applied Bio-Sciences .

2016.3(1):6-10.