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Urinary bladder biopsy with denuded mucosa: Denuding cystitis—Cytopathologic correlates
Author(s) -
Parwani Anil V.,
Levi Angelique W.,
Epstein Jonathan I.,
Ali Syed Z.
Publication year - 2004
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.10406
Subject(s) - medicine , urothelium , cytology , carcinoma in situ , biopsy , urinary bladder , urinary system , pathology , urine cytology , carcinoma , cystoscopy , urothelial carcinoma , urology , cancer , bladder cancer
Denuding cystitis is often encountered in tissue biopsies of bladder mucosa performed by either cold‐cup forceps or wire loop electrocautery to evaluate hematuria or to rule out recurrent urothelial carcinoma. Lack of urothelium in these biopsies is often a frustrating experience, leading to a nonspecific interpretation. In this study, 151 cases of denuding cystitis were retrieved from the surgical pathology files of The Johns Hopkins Hospital over a 4‐year period (1996–1999). Patients under the age of 40 years and outside consultation material were excluded. Of the 151 cases of denuding cystitis, 48 patients were identified who had concurrent urinary cytologic studies. Of these patients, 35 were male (73%) and 13 were female (27%). Patient ages ranged from 43 to 85 years (mean, 67). Twenty‐six of these 48 patients (54%) had at least one concurrently positive urinary cytology, which was histologically confirmed. All except three cases were high‐grade urothelial carcinoma with the following histologic subtypes: flat carcinoma in situ (n = 11), noninvasive papillary (n = 9), and invasive urothelial carcinoma (n = 3). We conclude that urinary cytology is a sensitive modality that detects exfoliated carcinoma cells in patients with a histologic diagnosis of denuding cystitis. An inconclusive diagnosis of denuding cystitis on tissue might be related to biopsy method and technique, small sample size, or biopsy of cystoscopically abnormal urothelium that is denuded. A cytologic diagnosis of high‐grade urothelial carcinoma in these cases leads to a timely clinical intervention for optimal patient management. Diagn. Cytopathol. 2004;30:297–300. © 2004 Wiley‐Liss, Inc.