The Spectrum of Polyoma Virus and Polyoma Virus-Like Changes in Urine Cytology: When Should an Atypical Diagnosis Be Considered.

IF 1 4区医学 Q4 MEDICAL LABORATORY TECHNOLOGY

Diagnostic Cytopathology Pub Date : 2025-06-09 DOI:10.1002/dc.25494

Yaogong Li, Yonca Kanber, Derin Caglar, Wassim Kassouf, Manon Auger, Fadi Brimo

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Abstract

Background: While the Paris system for reporting urinary cytology states that cells with well-recognized and typical changes of polyoma virus (PV) infection should not lead to a diagnosis of 'atypia, the prognostic significance of PV-like features is unknown.

Methods: Included were 284 urine cytology cases with PV or PV-like changes. Four cell types were identified. Cell A was typical of PV infection, cell B had a spider-web chromatin pattern, and cells C and D were degenerated cells with clumpy chromatin or homogeneous severely hyperchromatic nuclei, respectively. Events were correlated with a subsequent histological diagnosis of high-grade urothelial carcinoma (HGUC).

Results: 47% of cases had more than one cell type. The most common cell was D (64%) and the least common was A (27%). The most common cell to be present in isolation was D (n = 109, 60%). 92% of cases with cell A had other cell types. Overall, the presence of cell A was associated with a benign follow-up (1.2% association with HGUC). There was a gradual increase in the association with a HGUC diagnosis in cases with cells B (PPV = 8%), C (PPV = 15.5%), and D (PPV = 44%). The presence of only cells B, C, or D was predictive of HGUC in 22.4%, 33.3%, and 61.5%, respectively.

Conclusions: Cases with cell type A can be confidently diagnosed as 'negative for HGUC', even in the presence of associated cells with PV-like changes. Cases with cells displaying PV-like features (cell type B, C, or D) in the absence of type A features may represent degenerated HGUC cells.

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尿细胞学中多瘤病毒和多瘤病毒样改变的谱：何时应考虑非典型诊断。

背景：巴黎泌尿细胞学报告系统指出，具有多瘤病毒（PV）感染的典型变化的细胞不应被诊断为“异型”，但PV样特征的预后意义尚不清楚。方法：284例尿细胞学检查显示PV或PV样改变。鉴定出四种细胞类型。细胞A为典型的PV感染，细胞B为蜘蛛网状染色质，细胞C和细胞D分别为染色质团块或均匀性严重深染的变性细胞。这些事件与随后的高级别尿路上皮癌（HGUC）的组织学诊断相关。结果：47%的病例有一种以上的细胞类型。最常见的是D细胞（64%），最不常见的是A细胞（27%）。最常见的分离细胞是D （n = 109,60 %）。92%的A细胞患者有其他细胞类型。总体而言，A细胞的存在与良性随访相关（与HGUC相关1.2%）。在B细胞（PPV = 8%）、C细胞（PPV = 15.5%）和D细胞（PPV = 44%）的病例中，与HGUC诊断的相关性逐渐增加。仅存在B、C或D细胞预测HGUC的比例分别为22.4%、33.3%和61.5%。结论：即使存在与pv样变化相关的细胞，A型细胞病例也可以被自信地诊断为“HGUC阴性”。在没有A型特征的情况下，细胞表现为pv样特征（B、C或D型细胞）可能是退化的HGUC细胞。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnostic Cytopathology 医学-病理学

CiteScore

2.60

自引率

7.70%

发文量

163

审稿时长

3-6 weeks

期刊介绍： Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.