The nuclei however are regular and pale (TP). Some umbrella cells show reactive features with prominent single and multiple nucleoli. ( a) The cytological features of catheterized urine (CU) are usually similar to voided samples, except for higher cellularity, more sheets, clusters and urothelial tissue fragments, and background inflammation. Giant umbrella cells may be mistaken as neoplastic (TP)Ĭatheterized urine. They are normally seen in specimens from ureter or renal pelves. ( c) Multinucleated umbrella cells are rare in voided urine, except after diagnostic and therapeutic procedures. They desquamate singly or in clusters (TP). These cells are often spherical or round with scanty basophilic cytoplasm and spherical bland nucleus. ( b) Intermediate cells originating from the deeper layers of the urothelium: resemble parabasal squamous cells from lower genital tract in size and configuration. The nuclei are central and round with regular finely granular chromatin and occasional small nucleoli (SP). Umbrella cells may be mono-, bi-, or multinucleated. They are somewhat similar in size to cervicovaginal intermediate squamous cells, but may be larger. Umbrella cells are the predominant cell type in voided urine and are 20–30 μm in diameter, with one flat plane. These cells are of various types, shapes, and sizes and comprise superficial (umbrella) cells and a few cells from the intermediate and deeper urothelial cell layers. ( a) Superficial (umbrella) cells: normal voided urine may contain relatively few urothelial cells. Many of these categories utilize strict cytomorphological criteria and in particular focus on nuclear-to-cytoplasmic ratio, hyperchromasia, nuclear border irregularity, and chromatin quality (Figs. TPS diagnostic categories include negative for HGUC (NHGUC) atypical urothelial cells (AUC) suspicious for HGUC (SHGUC), HGUC, LGUN and other malignancies, both primary and secondary. The reporting system is sponsored by the American Society of Cytopathology (ASC) and the International Academy of Cytology (IAC). The primary emphasis of TPS is the detection of high-grade urothelial carcinoma (HGUC), with the understanding that urinary cytology has low sensitivity, specificity, and reproducibility for the detection of low-grade urothelial neoplasms (LGUN). TPS guidelines are based on consensus, global participation, and evidence-based practice. The system was conceived by participants of two urine cytology symposia in 2013 at the 18th International Congress of Cytology (ICC) held in Paris. The Paris System (TPS) is a standardized international reporting system for urinary cytology specimens.
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