Maria Luisa C. Policarpio-Nicolas, Patrick J. McIntire
{"title":"尿液细胞学中热灼伪影的病例系列：尿液细胞学中的热灼伪影：一种不常见的发现，但却是一个潜在的陷阱。","authors":"Maria Luisa C. Policarpio-Nicolas, Patrick J. McIntire","doi":"10.1002/dc.25419","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Therapeutic modalities used in bladder lesions/neoplasms (electrocautery, fulguration, and laser) could produce morphologic alterations leading to diagnostic challenges. While often seen on histology, they can present in urine cytology as atypia or even raise the concern for malignancy. Herein, we present clinicopathologic findings of four patients with cautery artifact in urine cytology.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The authors' lists and a computerized search of urine cytology with features of thermal cautery artifact were collated. Slides and clinicopathologic variables (prior specimens, concurrent and follow-up surgical specimens, age, sex, manner of urine collection, cystoscopy, and treatment procedure during cystoscopy) were reviewed.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Four cases were identified. Procedures performed during cystoscopy included laser therapy (<i>n</i> = 2), postbiopsy cauterization (<i>n</i> = 1), and fulguration (<i>n</i> = 1). All cases showed spindled cells with delicate bipolar cytoplasm, “cigar-shaped” nuclei, smooth to slightly irregular nuclear membranes, and arranged singly and loosely cohesive to lamellar stacks. Few atypical well-preserved, undistorted cells were identified in 2/4. The concurrent biopsies showed superficial cellular fragments with thermal artifact (<i>n</i> = 1) and rare atypical cells (<i>n</i> = 2). Follow-up biopsies in two cases had high-grade urothelial carcinoma both of which were diagnosed as atypical urothelial cells on cytology.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Thermal cautery artifact in urine cytology is rare and can be seen following laser, electrocautery, and fulguration. The spindling artifact can render some degree of difficulty in assessing for the presence of urothelial atypia both in cytology and biopsy. Familiarity with these cytologic features, knowledge of the treatment procedure, attention to the cytologic findings of well-preserved cells and repeat sampling in cases with atypical urothelial cells in patients with history of malignancy is essential.</p>\n </section>\n </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 2","pages":"72-75"},"PeriodicalIF":1.0000,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688623/pdf/","citationCount":"0","resultStr":"{\"title\":\"Case Series of Thermal Cautery Artifact in Urine Cytology: An Uncommon Finding but a Potential Pitfall\",\"authors\":\"Maria Luisa C. Policarpio-Nicolas, Patrick J. McIntire\",\"doi\":\"10.1002/dc.25419\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Therapeutic modalities used in bladder lesions/neoplasms (electrocautery, fulguration, and laser) could produce morphologic alterations leading to diagnostic challenges. While often seen on histology, they can present in urine cytology as atypia or even raise the concern for malignancy. Herein, we present clinicopathologic findings of four patients with cautery artifact in urine cytology.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>The authors' lists and a computerized search of urine cytology with features of thermal cautery artifact were collated. Slides and clinicopathologic variables (prior specimens, concurrent and follow-up surgical specimens, age, sex, manner of urine collection, cystoscopy, and treatment procedure during cystoscopy) were reviewed.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Four cases were identified. Procedures performed during cystoscopy included laser therapy (<i>n</i> = 2), postbiopsy cauterization (<i>n</i> = 1), and fulguration (<i>n</i> = 1). All cases showed spindled cells with delicate bipolar cytoplasm, “cigar-shaped” nuclei, smooth to slightly irregular nuclear membranes, and arranged singly and loosely cohesive to lamellar stacks. Few atypical well-preserved, undistorted cells were identified in 2/4. The concurrent biopsies showed superficial cellular fragments with thermal artifact (<i>n</i> = 1) and rare atypical cells (<i>n</i> = 2). Follow-up biopsies in two cases had high-grade urothelial carcinoma both of which were diagnosed as atypical urothelial cells on cytology.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Thermal cautery artifact in urine cytology is rare and can be seen following laser, electrocautery, and fulguration. The spindling artifact can render some degree of difficulty in assessing for the presence of urothelial atypia both in cytology and biopsy. Familiarity with these cytologic features, knowledge of the treatment procedure, attention to the cytologic findings of well-preserved cells and repeat sampling in cases with atypical urothelial cells in patients with history of malignancy is essential.</p>\\n </section>\\n </div>\",\"PeriodicalId\":11349,\"journal\":{\"name\":\"Diagnostic Cytopathology\",\"volume\":\"53 2\",\"pages\":\"72-75\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2024-11-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688623/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diagnostic Cytopathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/dc.25419\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"MEDICAL LABORATORY TECHNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnostic Cytopathology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/dc.25419","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}
Case Series of Thermal Cautery Artifact in Urine Cytology: An Uncommon Finding but a Potential Pitfall
Background
Therapeutic modalities used in bladder lesions/neoplasms (electrocautery, fulguration, and laser) could produce morphologic alterations leading to diagnostic challenges. While often seen on histology, they can present in urine cytology as atypia or even raise the concern for malignancy. Herein, we present clinicopathologic findings of four patients with cautery artifact in urine cytology.
Methods
The authors' lists and a computerized search of urine cytology with features of thermal cautery artifact were collated. Slides and clinicopathologic variables (prior specimens, concurrent and follow-up surgical specimens, age, sex, manner of urine collection, cystoscopy, and treatment procedure during cystoscopy) were reviewed.
Results
Four cases were identified. Procedures performed during cystoscopy included laser therapy (n = 2), postbiopsy cauterization (n = 1), and fulguration (n = 1). All cases showed spindled cells with delicate bipolar cytoplasm, “cigar-shaped” nuclei, smooth to slightly irregular nuclear membranes, and arranged singly and loosely cohesive to lamellar stacks. Few atypical well-preserved, undistorted cells were identified in 2/4. The concurrent biopsies showed superficial cellular fragments with thermal artifact (n = 1) and rare atypical cells (n = 2). Follow-up biopsies in two cases had high-grade urothelial carcinoma both of which were diagnosed as atypical urothelial cells on cytology.
Conclusion
Thermal cautery artifact in urine cytology is rare and can be seen following laser, electrocautery, and fulguration. The spindling artifact can render some degree of difficulty in assessing for the presence of urothelial atypia both in cytology and biopsy. Familiarity with these cytologic features, knowledge of the treatment procedure, attention to the cytologic findings of well-preserved cells and repeat sampling in cases with atypical urothelial cells in patients with history of malignancy is essential.
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.
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