The Paris System for Reporting Urinary Cytology

Dedication
Foreword
	From Bethesda to Paris—At Last We Have Standardized Terminology for Urinary Cytology!
Prologue
Abbreviations
Contents
Editors
Contributors
Chapter 1: Pathogenesis of Urothelial Carcinoma
	Background
	Two Pathways of Neoplastic Transformation of Urothelium
	References
Chapter 2: Adequacy of Urine Specimens (Adequacy)
	Introduction
	The Adequacy Algorithm
	Volume and Adequacy
	Adequacy of Instrumented Urinary Tract Cytology Specimens
	The Less-Than-Optimal Adequacy Category
	Recommendations
	References
Chapter 3: Negative for High-Grade Urothelial Carcinoma (Negative)
	Background
	Definition of Negative for High-Grade Urothelial Carcinoma
	Criteria of Components of NHGUC
		Benign Superficial (Umbrella) Urothelial Cells
		Squamous Epithelial Cells, Both Superficial and Intermediate
		Glandular Cells
		Benign Urothelial Tissue Fragments
			Benign Urothelial Tissue Fragments in Voided Urine
			Benign Urothelial Tissue Fragments in Instrumented Urine
			Clusters, Groups, or Sheets of Urothelial Cells
			Three-Dimensional Urothelial Tissue Fragments with Nephrolithiasis
			Urothelium with Nephrolithiasis: Sheets or Clusters/Groups
		Urothelial Changes Characteristic of Infectious Processes
			Acute Bacterial Infections
			Characteristic Viral Cytopathic Effects
		Urothelial Changes Associated with Treatment Effects
			Radiation
			Immunotherapy
			Chemotherapy
		Seminal Vesicle Cells
		Bladder Diversion Urine
	The Rate of Negative Samples in a Usual Laboratory Population
	Risk of Malignancy
	References
Chapter 4: Atypical Urothelial Cells (AUC)
	Background
	Definition
	Criteria
	Explanatory Notes
	Rate and Risk of Malignancy
	References
Chapter 5: Suspicious for High-Grade Urothelial Carcinoma (Suspicious)
	Background
	Definition
	Criteria
	Explanatory Notes
	Rate and Risk of Malignancy
	References
Chapter 6: High-Grade Urothelial Carcinoma (HGUC)
	Background
		Historical Review of Reporting System of Urine Cytology
		The Meaning of Positive Urine Cytology
		The Importance of Tumor Grade as a Prognostic Factor
		The Cytologic Characteristics of HGUC
	Definition
		Histologic Definition of HGUC
		Histologic Definition of Carcinoma In Situ
		Cytologic Definition of HGUC
		Definition of HGUC with Squamous Differentiation
		Definition of HGUC with Glandular Differentiation
	Criteria of Malignancy
		Other Notable Cytomorphologic Features
	Explanatory Notes
	Rate of Malignancy
	Risk of Malignancy
	References
Chapter 7: Low-Grade Urothelial Neoplasia (LGUN)
	Background
	Definitions
		Histologic Definition of Urothelial Papilloma [8]
		Histologic Definition of Papillary Urothelial Neoplasm of Low Malignant Potential [8]
		Histologic Definition of Low-Grade Papillary Urothelial Carcinoma [8]
		Histologic Definition of Urothelial Dysplasia: Flat Low-Grade Intraurothelial Neoplasia [8]
		Cytologic Definition of Low-Grade Urothelial Neoplasia
	Cytologic Criteria of LGUN (Regardless of the Specimen Type: Voided or Instrumented)
	Explanatory Notes
	Rate of Recurrence and Risk of Progression
	References
Chapter 8: Other Malignancies Primary and Metastatic and Miscellaneous Lesions
	Primary Non-Urothelial Tumors
		Epithelial Malignancies
			Squamous Cell Carcinoma
				Background
				Definition
				Diagnostic Criteria
				Liquid-Based Preparations (LBP)
			Adenocarcinoma
				Background
				Definition
				Criteria
			Neuroendocrine Tumors
				Small Cell Carcinoma and Large Cell Neuroendocrine Carcinoma
					Background
					Definition of SmCC
					Criteria
					LBPs [6, 18] (see Figs. 8.15 and 8.16)
		Non-Epithelial Malignancies
			Sarcoma
			Hematologic Malignancy
			Melanoma
	Direct Extension and Metastatic Tumors to Urinary bladder
		Background
		Direct Extension (Carcinomas of Prostate, Colon, Rectum, Uterine Cervix)
			AdCa of Prostate
			Colorectal AdCa
			SqCC of Uterine Cervix
		Metastatic Tumors (Renal Cell, Breast, Ovarian, Lung, Stomach and Skin Carcinoma, Melanoma and Hematologic Malignancies)
			Renal Cell Carcinoma (RCC)
			Breast Carcinoma
			Gastric Carcinoma
	Non-Epithelial Benign Tumors and Tumor-Like Conditions
		Non-Epithelial Benign Tumors
			Pheochromocytoma/Paraganglioma
		Tumor-Like Lesions
			Nephrogenic Adenoma
			Amyloidosis
			Inflammatory Pseudotumor (Pseudosarcomatous Fibromyxoid Tumor)
	References
Chapter 9: Ancillary Studies in Urinary Cytology
	Background
	Pre-analytical Procedures, Technique, and Evaluation of UroVysion® FISH
		Specimen Preparation
		Analysis of FISH Signals
	Imaging and Automation of UroVysion® FISH Analysis
		Advantages of an Automated Imaging System
		Details of Automated Imaging Systems
		Target FISH
		Reporting of Results
	Performance of UroVysion® FISH Testing
		UroVysion FISH in Atypical Urinary Cytology
		Cost-Effectiveness of UroVysion FISH
	Pitfalls in UroVysion® FISH Analysis
	ImmunoCyt/uCyt+ and Other Cell-Based Tests
		ImmunoCyt/uCyt+ Test
		Other Cell-Based Tests
	Liquid-Based Tests
		BTA Test
		The NMP22 Test
		Other Liquid-Based Biomarkers
	Conclusions
	Sample Reports UroVysion FISH
	Appendix
		UroVysion® Assay
		Automated Imaging Systems for UroVysion® FISH Analysis
	References
Chapter 10: Cytopreparatory Techniques
	Background
	Materials and Methods
		Collection
		Processing
	Preparation Methods
	Discussion
	Conclusions and Recommendations
	References
Chapter 11: Clinical Management
	Background
	Management of Negative for High Grade Urothelial Carcinoma (NHGUC)
	Management of Atypical Urothelial Cells
	Management of Suspicious/Positive for High Grade Urothelial Carcinoma
	Management of Low Grade Urothelial Neoplasms
	Management of Non-urothelial Tumors
	Management of the Unsatisfactory Specimen
	Management
	Conclusions
	References
Afterword: The Paris System for Reporting Urinary Cytology
	Future Clinical and Research Needs for All Diagnostic Categories of The Paris System for Reporting Urinary Cytology
Index