"Negative for high grade urothelial carcinoma"
is the term used in The Paris System (TPS) for Reporting Urinary Cytology was proposed in the 2013 International Cytology Congress in Paris, France. The finalized recommendations of TPS were officially released in 2016. Since then it seems it has become the standard for cytology reporting. TPS is intended to eliminate great variability by which urinary tract cytology specimens are assessed between individuals and institutions. Of particular concern was the inconsistent and high rate of indeterminate diagnoses, such as "atypical". Diagnostic categories for TPS are as follows.
1. Negative for High Grade Urothelial Carcinoma
2. Atypical urothelial cells
3. Suspicious for High Grade Urothelial Carcinoma
4. High Grade Urothelial Carcinoma
5. Low Grade Urothelial Neoplasm
6 Other malignancies, both primary and secondary
Prior to TPS, 1. Negative for High Grade Urothelial Carcinoma was Negative for malignant cells, and 5. Low Grade Urothelial Neoplasm was Low Grade Urothelial Carcinoma.
In TPS, criteria for atypical urothelial cells are cells where cytologic changes fall short of a diagnosis of 33. Suspicious for High Grade Urothelial Carcinoma or 4. High Grade Urothelial Carcinoma, and meet the following requirement.
Major criterion (required) - Non-superficial and (non-degenerated) urothelial cells with an high N/C (Nucleus / Cytoplasm) ratio > 0.5
Minor criteria (1 required)
- Nuclear hyperchromasia
- irregular nuclear membranes
- Irregular, coarse, clumped chromatin
In Moffitt Caner Center, FL, cases if Atypical has been reduced from 27% cases in 2015 prior TPS to 10% in 2016 after TPS.
In terms of the diagnosis of "Negative for high grade urothelial carcinoma", according to Dr. Adeniran, MD, Director of cytopathology of Yale school of Medicine, risk of malignancy is 0-10%. So, this is a very good news.
Squamous cell present is likely contamination from another part of body.
Below is Dr. Abbosh of Fox Chace Cancer Center, PA answering to a patient's question about the subject in a webinar.
I'll mention, there's a question in the pre-webinar, that was solicited pre-webinar, about squamous cells. squamous cells, again, may sound very malignant, but they're really just normal cells that are sloughed off by the urinary tract into the urine, and they're detected by the pathologist, the cytopathologist. They're really just very... Really, they look like large flat cells with a very
small nucleus and a lot of cytoplasm. They're often considered contaminants. So, you guys may
remember, if you give a urine sample in your doctor's office, they will often give you a little sanitary pad
or sanitary napkin to sort of clean off the opening of your urethra. The point of doing that is to try to
reduce the number of squamous cells in the urine sample because, as I mentioned, they tend to be
The comment is also echoed in a government site saying about squamous cells in urine test.
There are three types of epithelial cells that line the urinary tract. They are called transitional cells, renal (kidney) tubular cells, and squamous cells. If there are squamous epithelial cells in your urine, it may mean your sample was contaminated. This means that the sample contains cells from another part of the body. This can happen if you do not clean your genital area well enough when collecting your urine sample with the clean catch method.
Also, Libre Pathology (Wikipedia of pathology) site says often Large (benign) squamous component in urine cytology is not reported.