• The Korean Journal of Cytopathology
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• v.10 no.1
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• pp.67-71
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• 1999

We report a case of 53-year-old man with plasmacytold transitional cell carcinoma of the urinary bladder, which may be confused with plasmacytoma. The patient initially presented with gross hematuria and dysuria for two months. Cystoscopy and radiologic studios revealed multiple intraluminal protruding masses on the urinary bladder invading perivesical fat tissue. After urinary cytologic examination and cystoscopic biopsy, radical cystectomy and pelvic lymph node dissections were done. Urine cytology showed single cells and poorly cohesive cells with round eccentric nuclei, bi-or multi-nucleation, indistinct nucleoli, coarse chromatin, and abundant basophilic cytoplasm within relatively clear background. The cytologic findings of tumor cells were similar to the plasma cells seen in plasmacytoma. The tumor of the bladder was composed on discohesive, individual cancer cells with diffuse pattern that simulated lymphoma or plasmacytoma. Immunohistochemical and electron microscopic studies clearly established the epithelial nature of the neoplasm. Recognition of this plasmacytoid type of transitional cell carcinoma of the urinary bladder can avoid the misdiagnosis.

• The Korean Journal of Cytopathology
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• v.5 no.1
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• pp.71-73
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• 1994

Rhabdomyosarcomas are found mainly in young patients, but rare in adults. A correlated cytological and histologic study of one case of embryonal rhabdomyosarcoma is presented. The cytologic appearance of the urine smear corresponded well with the histologic findings. Cytologically, two main cell types were distinguished ; a predominant primitive, small round cell with scant cytoplasm and a large cell with abundant cytoplasm. The cytologic feature proving rhabdomyoblastic differentiation, such as cross-striation, was absent.

• The Korean Journal of Cytopathology
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• v.7 no.2
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• pp.192-196
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• 1996

The principal significance of the urothelial changes caused by polyomavirus activation is in an erroneous diagnosis of urothelial cancer; however, the clue to their benign nature is the smooth structureless nuclear configuration and the relative paucity of affected cells. Though virologic studies and electron microscopy are usually needed to firmly establish the diagnosis, cytology is the most readily available and rapid means of establishing a presumptive diagnosis of human polyomavirus infection. A urine specimen of a 24-year-old man with hemorrhagic cystitis beginning two months after bone marrow transplantation for acute myeloblastic leukemia(M2) was submitted for cytologic evaluation. Cytologic findings revealed a few inclusion-bearing epithelial cells intermingled with erythrocytes, neutrophils, lymphocytes, and macrophages. Most of the inclusion-bearing fells had large, round to ovoid nuclei almost completely filled with homogeneous dark, basophilic inclusion. The chromatin was clumped along the periphery and the cytoplasm was mostly degenerated. The other cells exhibited irregular inclusions attached to the nuclear membrane surrounded by an indistinct halo. These findings were consistent with polyomavirus infection.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6283-6286
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• 2014

In patients with microscopic hematuria there is a need for better identification of those who are at greater risk of harbouring bladder tumors. The RisikoCheck(C) questionnaire has a strong correlation with the presence of urothelial carcinoma (UC) of the bladder and in combination with other available tests may help identify patients who require detailed clinical investigations due to increased risk of presence of bladder tumors. This study aimed to evaluate the efficacy of RisikoCheck(C) questionnaire together with NMP-22(R) (BladderChek(R)) as a point-of-care urine test in predicting the presence of bladder tumors in patients presenting with microscopic hematuria as the sole finding. In this multi-institutional prospective evaluation of 303 consecutive patients without a history of urothelial carcinoma (UC), RisikoCheck(C) risk group assessment, urinary tract imaging and cystourethroscopy as well as urine cytology and Nuclear Matrix Protein-22 (NMP-22 BladderChek) testing were performed where available. The sensitivity, specificity, negative predictive value (NPV), and positive predictive values (PPV) for the risk adapted approach were calculated. All patients underwent cystoscopy, and tumors were detected in 18 (5.9%). Urine cytology and NMP-22 was positive for malignancy in 9 (3.2%) and 12 (7.5%) of patients, respectively. A total of 43 (14%) patients were in the high risk group according to the RisikoCheck(C) questionnaire. The sensitivity and specificity of the questionnaire in detecting a bladder tumor was 61.5 % and 84.0 % in the high risk group. In patients with either a positive NMP-22 test or high risk category RisikoCheck(C), 23.6% had bladder tumors with a corresponding sensitivity of 54.2% and specificity of 88.6%. If both tests were negative only 3.3% of the patients had bladder tumors. The results of our study suggest that the efficacy of diagnostic evaluation of patients with microscopic hematuria may be further enhanced by combining RisikoCheck(C) questionnaire with NMP-22.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5519-5525
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• 2013

Background: Cervical cancer is the second most common cancer in Thai women after breast cancer. Currently, the Papanicolaou (Pap) smear is the recommended procedure for cervical cancer screening in Thailand, but only a relatively small percentage of women follow this screening program. An alternative method to detect HPV genotypes associated with cervical cancer is self-sampling of urine, which is a more widely accepted method. Our study aimed to evaluate the prevalence of HPV in Thai women using urine and cervical swabs and prevalence of HPV in Thai men using urine samples. Materials and Methods: Tumorigenic HPV detection was accomplished by electrochemical DNA chip and PCR/direct sequencing. In addition to HPV prevalence, we report the concordance between different methods and sample types. One-hundred and sixteen women and 100 men were recruited. Histological examination revealed normal cytology in 52 women, atypical squamous cells of undetermined significance (ASCUS) in 9, low-grade squamous intraepithelial lesions (LSIL) in 24, and high-grade squamous intraepithelial lesions (HSIL) in 31. One-hundred men were classified as heterosexuals (n=45) and homosexuals (n=55). Results: The most prevalent HPV genotype in our study was HPV16. The HPV detection rate was generally lower in urine samples compared with cervical samples. Overall, there was good agreement for the detection of carcinogenic HPV from female cervical samples between the DNA chip and PCR/sequencing, with 88.8% total agreement and a kappa value of 0.76. In male urine samples, the level of agreement was higher in heterosexuals compared with homosexuals. Conclusions: Further improvement is required to increase an overall yield of HPV DNA detection in urine samples before clinical application of a urine-based HPV screening program. The electrochemical DNA chip test is a promising technique for carcinogenic HPV detection.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.81-85
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• 2013

Background: Early diagnosis of carcinoma of bladder remains a challenge. Survivin, a member of the inhibitor of apoptosis (IAP) protein family, is frequently activated in bladder carcinoma. The objective of this study was to investigate urinary survivin as a marker for diagnosis of urinary bladder. Materials and Methods: We examined urinary survivin concentration in 28 healthy individuals, 46 positive controls and 117 cases of histologically proven TCC prior to transurethral resection, using ELISA, and compared values with findings for urinary cytology. Results: Survivin was found to be significantly higher in the cancer group (P<0.05). A cut off value of 17.7 pg/ml was proposed, with an approximate sensitivity of 82.9% and specificity of 81.1% (P<0.0001), whereas urine cytology had a sensitivity of 66.7% and a specificity of 96.0%. Conclusions: Urinary survivin can be used as a non-invasive diagnostic biomarker for TCC bladder, both for primary and recurrent disease.

• The Korean Journal of Cytopathology
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• v.12 no.2
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• pp.121-125
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• 2001

Primary small cell carcinoma of the urinary bladder is a rare malignant tumor. A more rapidly fatal course may be seen in advanced stages of small cell carcinoma as compared to similar stages of urothelial carcinoma. It is very important to recognize this distinct form of bladder cancer by urinary cytology The differential diagnosis of small cell carcinoma of the urinary bladder includes metastatic small cell carcinoma, urothelial carcinoma, and primary or secondary malignant lymphoma. This article highlights the urinary cytologic diagnosis of a case of primary small cell carcinoma. A 59-year-old male presented with gross hematuria for five months. Urinary cytology showed high cellularity consisting of tiny monotonous tumor cells in the necrotic background. The tumor cells occurred predominantly singly, but a few in clusters. The cytoplasm was so scanty that only a very narrow rim of it was seen. The nuclei were oval or round and had finely stippled chromatin. Rarely, the nuclei contain visible nucleoli. Frequently cell molding was noted in clusters. Many single cells demonstrated nuclear pyknosis or karyorrhexis. The histologic findings of transurethral resection and partial cystectomy specimen were those of small cell carcinoma. Cytologic distinction may be very difficult but careful attention to clinical features and cellualr details can classify these neoplasms correctly.

• The Korean Journal of Nuclear Medicine
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• v.35 no.3
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• pp.192-197
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• 2001

Purpose: Urinary cytology and cystoscopic exam are effective methods for diagnosis of transitional cell carcinoma(TCC). But the former shows drawbacks such as the need for a well-trained examiner, and wide imprecision related to the variability of microscopic exam; the latter is an invasive method. $UBC^{TM}$ test detects the epitope on specific cytokeratin fragments released from epithelium of bladder cancer by immunoradiometric assay. We compared $UBC^{TM}$ test with urinary cytology for diagnosis of TCC to evaluate the utility of $UBC^{TM}$ test. Materials and Methods: Eighty-four patients with hematuria were included in our study. $UBC^{TM}$ tests (IDL Biotech, Sweden) were assayed in mid-stream urine according to the ordinary assay protocol. Nineteen patients were confirmed as TCC by cystoscopic examination and underwent transurethral resection (Group A). Other patients had various benign urinary tract conditions (Group B). Samples were considered positive as the $UBC^{TM}$ concentration was greater than $12{\mu}g/L$. Results: $UBC^{TM}$ levels were significantly different between group A ($95.9{\pm}166.4\;{\mu}g/L$) and group B ($19.2{\pm}85.6{\mu}g/L$) (P<0.001). Sensitivity for diagnosis of TCC was 89.5% (17/19) in UBC test and 47.4% (9/19) in cytology (p<0.05). Specificity for diagnosis of TCC was 81.5% (53/65) in $UBC^{TM}$ test and 100% (65/65) in cytology. $UBC^{TM}$ test was significantly more sensitive in stage Ta, $T_1$ tumors (84.6 vs 38.5%, p<0.05) and in grade I (83.3% vs 16.7%, p<0.05) than cytology. $UBC^{TM}$ test showed a tendency to be more sensitive as the grade was higher (83.3% in Grade I, 90% in Grade II and 100% in Grade III). Conclusion: $UBC^{TM}$ test could be a useful method in distinguishing TCC from other benign genitourinary diseases. Moreover, $UBC^{TM}$ test could be an especially valuable marker for diagnosis of TCC in patients with early TCC of low grade TCC compared to urinary cytology. Therefore, mbined use of $UBC^{TM}$ test in association with cytology is helpful to overcome the limited sensitivity of cytology.

• The Journal of the Korean life insurance medical association
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• v.33 no.2
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• pp.18-24
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• 2014

Bladder cancer is one of the most common cancers affecting men and women and thus has a profound impact on health care. The majority of patients (75%) with newly diagnosed urothelial tumors have non-muscle invasive disease confined to the bladder mucosa or the lamina propria. The most important risk factors for the development of bladder cancer are smoking and occupational exposure to toxic chemicals. Painless visible hematuria is the most common presenting symptom of bladder cancer. Cystoscopy and urine cytology are currently the recommended tools for diagnosis of bladder cancer. Excluding muscle invasion is an important diagnostic step, as outcomes for patients with muscle invasive bladder cancer (MIBC) are less favorable. For non-muscle invasive bladder cancer (NMIBC), the high rate and frequency of recurrence and the concern for disease progression - especially in patients with high-risk tumors - mandate careful strategies for tumor surveillance. The surveillance strategies should be based on available prognostic factors and in particular data from the EORTC risk tables.

• BMB Reports
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• v.36 no.4
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• pp.399-402
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• 2003

Early detection of bladder cancer is particularly important since it dramatically affects the survival rates. However, neither urinary cytology nor tumor markers that are currently used are sensitive enough for the early detection of bladder cancer or recurrent disease. The ras genes are frequently mutated in cancer. In this study, we investigated the diagnostic potential of ras mutation analysis in urinary sediments of patients with bladder cancer using a single-strand conformation polymorphism analysis and polymerase chain reaction. Mutation in codon 12 of the H-ras gene was observed in 39% of the patients. Our results indicate that this approach may significantly improve diagnostic sensitivity in detecting bladder tumors.