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What do the cells in the urine say about your health?

Beauty in Urine Sample - 8 images

Dr  Sampurna Roy  MD   



Cytological analysis of urine is an important investigative tool in screening, diagnosis and follow up of urological malignancy, specially transitional cell carcinoma.

Eight pretty images for the "Uropathologists" and cytopathologists.  Enjoy!


      "Cellular Beauty in Urine Sample"



Urine sample post cystoscopy:  A sample taken at cystoscopy is typically very cellular and to the inexperienced pathologist may lead to the diagnosis of transitional carcinoma. This image shows clusters of round urothelial cells with smooth cytoplasmic border. The nuclear : cytoplasmic ratios are maintained and the chromatin pattern is normal.


Urine sample post cystoscopy: Elongated columnar-shaped urothelial cells.


Urine sample showing increased cellularity and dispersed population of malignant urothelial cells.


Benign and Malignant transitional cells in urine specimen.


Malignant Glandular group in a urine sample of a patient with locally extensive Dukes' B rectal adenocarcinoma. Distinctive features that suggest a colorectal primary include a necrotic backround containing glandular clusters composed of crowded columnar cells with elongated  pleomorphic nuclei and coarse chromatin.


Prostatic carcinoma in urine sample.

A prostatic primary should be suggested on finding poorly cohesive micro-acinar  groups of fairly uniform cells with prominent eosinophilic nucleoli and bland chromatin texture. Note the prominent nucleoli in the image.

High Gleason grade tumours may be difficult to distinguish from high grade transitional cell carcinoma, although often prominent nucleoli are evident in the former and may be an important diagnostic feature.



Radiotherapy effect on the urothelium may produce bizarre cell changes with nuclear enlargement, multinucleation, cytoplasmic vacuolation and bizzare cell forms. Although nuclear enlargement may be prominent, the nuclear:cytoplasmic ratio is maintained and dense hyperchromasia is not evident.

Given the cell changes post radiotherapy are bizarre one should be cautious before making a diagnosis of malignancy. If unequivocal malignant cells are not present, it is best to request repeat samples.


Renal tubular papillary group in the urine specimen.

It is quite common for normal urine to contain papillary groups of cells and these should not be over-interpreted as low-grade transitional cell carcinoma. 

Renal tubular epithelial cells may appear as tubulo-papillary structures that may masquerade as a low-grade urothelial neoplasm.

Some of these tubular cells appear distinct from usual urothelial cells with minimal cytoplasm and "bulging" nuclei.

Possibility of underlying renal parenchymal disease should be considered when red blood cell casts are present along with these  tubulo-papillary clusters.


 After writing this post I have a big grin on my face as it brought back some "Cool Memories".


Time to have a cold mocktail and watch a movie.

Have a great weekend. 




Dr  Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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