chromosomes are off

The first picture shows chromosome 3,7,17 and 9.   UroVysion test uses four probes each is attached with unique colored florescence. 
The probe to detect chromosome 3 is red, chromosome 7 is green,  and chromosome 17 is blue.  The probe to detect chromosome 9 which is missing a special section is yellow.  

The second picture shows the result of UroVysion test for a normal cell and abnormal cell. 
A is normal cell in cytology.  B is how the result of UroVysion FISH test looks like for the normal cell.
C is abnormal cell in cytology.  D is how the result of UroVysion FISH test looks like for the abnormal cell.

The interpretation of B

There are two red probes, indicating there are two chromosome 3.    This is normal as one from father and one from mother.
There are two green probes, indicating  there are two chromosome 7.    This is normal as one from father and one from mother.
There are two blue probes, indicating there are two chromosome 17.    This is normal as one from father and one from mother.
There are two blue probes, indicating  no missing section in  two chromosome 9.    This is normal.

The interpretation of D

There are  7 red probes, indicating there are 7 chromosome 3.    This is abnormal because there are 5 more chromosome 3 than norm.
There are  6 green probes, indicating there are 6 chromosome 7.   This is abnormal because there are 4 more chromosome 7 than norm.
There are  6 blue  probes, indicating there are 6 chromosome 17. This is abnormal because there are 4 more chromosome 17 than norm.
There are no yellow probes, indicating two chromosomes 9 are missing a special section.  This is abnormal.

This is just the review of one abnormal cell.  To call it POSITIVE the following conditions must be met.

> 4 cells with gain in probe signals (3> signals) in 2 different chromosomes or 2 different colors (red,green or blue).
>12 cells with a loss of the special section (no yellow) probe signals.

There are some cases UroVysion cannot be accurate.

If tumor < 5mm may become NEGATIVE because UroVysion depends on amount of tumoral cells in the slide of urine sample.  Tumor less than 5mm may not shred off enough numbers of tumor cells.

Test with abundant granulocytes or bacteria may not be informative

Test POSITIVE but no tumor cystoscopically present in bladder.   UroVysion tests says POSITIVE, but if urine is examine by cytology, it is possible that abnormal cells might have fallen from other places such as urethra, ureter, prostate and Kidney.   

 I wonder if Atypical in the report meant that  in addition to UroVysion FISH test, the pathologist might have done cytology test also  of the urine sample and found some cells looked Atypical.  

I do not know exact workflow of the lab who does UroVysion FISH test.

best

It has been known that cancer cells tend to have multiple chromosomes.  It has been known that chromosomes 3, 7 and 17 are associated with bladder cancer when multiple copies of chromosomes 3,7, 17 are found in urothelial cells.   UroVysion uses patter recognition tool FISH ( Fluorescence In Situ Hybridization) to find out if there are multiple copies of chromosome 3,7,17 in cells.   
Humans have 23 pairs of chromosomes - one from father and the other from mother which are stored in the nucleus of each cell. 22 pairs (chromosome 1 to 22) are the same in the father (male) and the mother (female).  So, a normal cell has two chromosome 3s, two chromosome 7s and two chromosome 17s and other 19 pairs of other chromosomes, and 23d pair of sex chromosomes.

Abnormal hybridization pattern exhibiting numerical abnormalities of chromosomes 3, 7, and 17 means UroVysion found  in urine sample several cells which have more than 2 chromosome 3, more than 2 chromosome 7, and more than 2 chromosome 17.  

For UroVysion, A positive test result was defined as one of the following: the presence of 4 or more morphologically abnormal cells of 25 analyzed cells that showed polysomy of 2 or more chromosomes 3, 7, and 17 in the same cell.   

In terms of Chromosome 9, the lack (missing)  of a certain section of Chromosome 9 is known to be associated with bladder cancer.  So, UroVysion checks how many cells' chromosome 9 are missing the specific section.   Because your FISH result says   Abnormal hybridization pattern exhibiting numerical abnormalities of chromosomes 3, 7, 9 and 17, they found that chromosome 9 in some cells in the urine is missing the specific section.  To call it positive for bladder cancer,  the analysis has to find 12 or more cells of which chromosome 9 is missing the specific section.   

Those counting of cells with abnormal number of chromosome 3,17,17 and cells with chromosome 9 which is missing the specific section are done manually by a technician or automatically.  Then a pathologist checks the report and gives a verdict.  

I do not understand that FISH said POSITIVE but ATYPICAL.  Did the report used the word POSITIVE?   Then I do not know what made the pathologist to say Atypical. 

The lab who conducted UroVysion Fish test of your urine, should have more detail information of their analysis. For example, they should have the data exactly how many cells had chromosome 9 which was missing the specific section, and how many copies of chromosome 3,7, and 17 are found in each abnormal cell.    

best

anyone know anything about the chromosome issue?

I've had a wide range of urine lab results, from negative (i.e. no cancer) to positive for urothelial carcinoma post turbt and bcg.  Most just say "abnormal" or "atypical" cells.
Since my cytos keep saying no new tumors, but my labs are ambiguous, my uro ordered a "FISH" to test my chromosomes.  Now my fish was positive, some chromosomes are not right, and it's "positive" but still just says "atypical cells."
The doc said if the FISH came back positive he wants to do another outpaitent procedure where he looks in the ureters and kidneys, but I had a horrible time of it when he did that a year ago dealing the stent.  The Norco that he gave me was basically worthless.  I almost ended up in the ER.
My FISH says:  Abnormal hybridization pattern exhibiting numerical abnormalities of chromosomes 3, 7, 9 and 17 - but it just ends up saying "atypical cells" again.
Where do I go from here?