American Urological Association - High Grade TCC/ CIS
High Grade TCC/ CIS
- Cytology is most useful for detecting flat CIS, which may be difficult to identify grossly.
- Cytologic features:
- Neoplastic cells usually exfoliate in large numbers and are poorly cohesive (shed singly or in small clusters).
- High N:C ratio.
- Nuclei are large, hyperchromatic, pleomorphic, with prominent red nucleoli (image A).
- Chromatin is coarsely clumped.
- Distinction between CIS and invasive TCC is tricky, but as a rule of thumb, the presence of necrotic debris (cell parts and lots of neutrophils) favors invasion (image B); CIS typically has a much cleaner background.