每月一例 2015 Jan

• Urine (left ureter washing cytology) • 65 y/o • r/o left ureter tumor • Figure 1-3

Your interpretation ?

Cytology findings • Figure 1:

– Necrotic background and degenerative atypical cells (indicating malignancy)

• Figure 2: – 4 pictures of clusters of abnormal cells with large

pleomorphic nuclei and increased N/C ratio (compatible with high grade urothelial carcinoma cells)

• Figure 3: – 4 pictures of tight clusters of abnormal cells with

hyperchromatic nuclei, scant cytoplasm, very high N/C ratio, molding nuclei and salt-and-pepper chromatin pattern (compatible with small cell carcinoma cells)

Diagnosis

Combined small cell carcinoma and high grade

urothelial carcinoma

Take home message

• Characteristic features of high grade urothelial carcinoma and small cell carcinoma

• The possibility of combined cancer (identification of two different types of cancer cells is important)