DR RSOWMYA,DR SRIDEVI M,DR. N. VIVEK RAJASIMHAN
DOI: https://doi.org/Background: Urine cytology remains a cornerstone in the diagnosis and prognosis of urothelial carcinoma. It continues to be widely utilized due to its distinct advantages, including ease of specimen collection and high patient compliance. This method plays a crucial role in both initial screening and long-term surveillance. However, its sensitivity can vary, particularly with low-grade tumors, necessitating histopathological correlation through tissue biopsies or resection specimens. When urine cytology is combined with histopathological evaluation, diagnostic accuracy significantly improves, enhancing the clinician’s ability to make informed decisions regarding treatment.
Aim: To describe and analyze the cytological characteristics of urothelial malignancy with histopathological grading
Methods: In this prospective observational study, urine samples from (n-70) patients with clinically suspected bladder carcinoma were examined using Papanicolaou-stained cytology. Histopathological evaluation of biopsy specimens followed standard grading protocols. Cytological parameters such as nuclear atypia, chromatin texture, mitotic activity, and cellular architecture were systematically compared against corresponding histological findings. Data collected, recorded and later analyzed.
Results: The study highlights that urothelial malignancies predominantly affect males in their 50s, with smoking as the leading risk factor. Hematuria is the most common symptom. Cytological evaluation using the Paris System shows moderate alignment with histopathology, with good sensitivity for high-grade tumors but limited accuracy for low-grade and atypical cases. Histopathology detects key morphological features more reliably. Cytology demonstrates strong diagnostic effectiveness (80%) and perfect positive predictive value, though its negative predictive value (81.8%) suggests missed malignancies. Interobserver agreement is highest for high-grade carcinoma, reinforcing its diagnostic clarity.
Conclusion: Structured cytological assessment, when mapped to histopathological benchmarks, offers enhanced diagnostic fidelity for urothelial carcinoma. This study advocates for integrative interpretation frameworks in pathology training to improve early detection and patient outcomes.
