***Under construction!***

Urine Cytology

Use the Paris system, which has the following primary categories (Acta Cytologica (2016) 60 (3): 185–197.)

UCD smartphrase: .CYNDU

– Nondiagnostic/Unsatisfactory

– Nondiagnostic/Unsatisfactory, Low-cellularity specimen

– Nondiagnostic/Unsatisfactory, Obscuring inflammation/lubricant      [select obscuring agent]

It’s thought that 2 well-visualized urothelial cells per high-power field in 10 consecutive high-power fields may serve as an objective measure of adequacy in instrumented urine specimens processed using the ThinPrep method.

Regardless of the specimen type (voided urine or instrumented), if the urothelial cells are completely obscured by lubricant or inflammatory cells, this represents an ‘unsatisfactory’ specimen. Conversely, if there are any atypical cells regardless of the overall cellularity this represents a satisfactory specimen.

 

UCD smartphrase: .NHGUC

– Negative for High-grade Urothelial Carcinoma

 

UCD smartphrase: .AUC

– Atypical Urothelial Cells

 

UCD smartphrase: .SFHGUC

– Suspicious for High-grade Urothelial Carcinoma

 

UCD smartphrase: .HGUC

– High-grade Urothelial Carcinoma

 

UCD smartphrase: .LGUC

– Low-grade Urothelial Carcinoma

 

 

Anal Pap Smears

Use the Bethesda system and CAP Protocol for the Reporting of Anal Cytology Specimens:

UCD smartphrase: .ANUNSAT

– Unsatisfactory for evaluation,   Insufficient nucleated squamous cellularity

 

UCD smartphrase: .ANOBSC

– Unsatisfactory for evaluation,  Obscuring blood/inflammation/acellular material        [pick limiting factor]

 

UCD smartphrase: .ANNILM

– Negative for intraepithelial lesion or malignancy (NILM)

– Transformation zone present/absent

 

UCD smartphrase: .ANASCUS

– Atypical squamous cells – undetermined significance (ASC-US)

– Transformation zone present/absent

 

UCD smartphrase: .ANASCH

– Atypical squamous cells cannot exclude High-grade squamous intraepithelial lesion (ASC-H)

– Transformation zone present/absent

 

UCD smartphrase: .ANLSIL

– Low-grade squamous intraepithelial lesion (LSIL)

– Transformation zone present/absent

 

UCD smartphrase: .ANHSIL

– High-grade squamous intraepithelial lesion (HSIL)

– Transformation zone present/absent

 

UCD smartphrase: .ANSCC

– Squamous cell carcinoma

– Transformation zone present/absent

 

UCD smartphrase: .ANAG

– Atypical glandular cells

– Transformation zone present/absent

 

 

 

Effusion Cytology

In general, use the “The International System for Serous Fluid Cytopathology”

 

Nondiagnostic

UCD smartphrase: .CYND

– Nondiagnostic

COMMENT: The specimen is paucicellular and there are insufficient cellular elements for a cytologic interpretation.

 

Additional explanation/detail can be added too:

UCD smartphrase: .CYNDEB

– Nondiagnostic, Exclusively blood

UCD smartphrase: .CYNDAC

– Nondiagnostic, Acellular specimen

 

 

Negative for malignancy

UCD smartphrase: .NFM

– Negative for malignancy

and any additional secondary diagnoses that may be helpful, such as

– Abundant acute inflammation

– Abundant chronic inflammation

 

 

Atypical

UCD smartphrase: .CYAUS

– Atypia of undetermined significance

COMMENT:  There are rare cells with mild atypia, which are uncertain significance.

 

UCD smartphrase: .CYALI

– Atypical lymphoid infiltrate (see comment)

COMMENT: There are abundant lymphocytes present. While these could represent chronic inflammation, if there is concern for a lymphoproliferative disorder, future specimens could be sent fresh for flow cytometry immunophenotyping as clinically necessary.

 

UCD smartphrase: .CYAMP

– Atypical mesothelial proliferation (see comment)

COMMENT: There are numerous large clusters of atypical cells that stain with multiple markers of mesothelial differentiation.  While these findings raise the possibility of mesothelioma, this diagnosis is challenging to make on cytology specimens. Accordingly, material is being sent for BAP1 immunohistochemistry and P16 FISH to evaluate as abnormal results could further support the diagnosis of mesothelioma.  Clinical and radiographic correlation is recommended.

 

 

Suspicious

UCD smartphrase: .CYSFM

– Suspicious for malignancy

COMMENT:  There are rare cells with moderate to marked cytologic atypia. These cells raise suspicion for malignancy, but their limited presence precludes a definitive diagnosis and additional analysis. Clinical correlation is recommended, with possible consideration for additional sampling as clinically indicated.

 

Malignant

UCD smartphrase: .CYMNT

– Malignant

 

UCD smartphrase: .CYMET

– Metastatic carcinoma, consistent with *** origin (see comment)

COMMENT: The cell block shows ***. A panel of immunohistochemical stains demonstrates that these cells stain with ***. Together, these findings are diagnostic of metastatic carcinoma and are consistent with *** origin. Clinical and radiographic correlation is recommended.

 

UCD smartphrase: .CYMETMUL

– Metastatic high-grade carcinoma, consistent with Mullerian origin (see comment)

COMMENT: The cell block shows malignant cells with high N:C ratios, irregular hyperchromatic nuclei, and prominent nucleoli. These cells stain positive for Ber-EP4, PAX8, WT-1, and strongly diffusely for P53 and P16. The morphologic and immunoprofile supports a diagnosis of high-grade serous carcinoma of tubo-ovarian origin.  Clinical and radiographic correlation is recommended.

 

UCD smartphrase: .CYMETSER

– Positive for serous neoplasm (see comment)

COMMENT: The patient’s history of an ovarian mass is noted. The cytology preparations show clusters of epithelial cells with only mild atypia.  These cells stain positive for Ber-EP4, PAX8, WT-1. There is wild-type staining with p53. Together, these findings are diagnostic of involvement by a serous neoplasm and are suggestive of a serous borderline tumor or related tumor. Correlation with the pending surgical pathology specimen is recommended.

 

Last updated: 4/12/24