The result of the Cytology came yesterday and it reads
Sample type: Urine
Method: Staining and Microscopy Result:
Smear shows few transitional and occasional epithelial cells. Many acute inflammatory cells, RBCs, amorphous deposits. Impression: No atypical cells in smear examined
Thanks to God all is well and the report is also clear. I am thinking of acute inflammation cells & RBCs which are there. We had last BCG on 24th June 2021 which was 40mg only in dose. Still there can be side effects of BCG which caused inflammation?
We are supposed to get another BCG in Jan-Feb 2022. Hopefully now Uro will suggest some reduced dose with 2 weeks duration between each BCG.
Waiting to meet Uro to suggest either Cystoscopy and then BCG or directly BCG without cystoscopy.
Our Uro wanted to check the ca cells in Urine so he recommended Urine Cytology. He wrote Urine cytology for M-Cells( Malignant Cells) in the prescription.
We have done it on Saturday 15th Jan 2022 and results are expected in 5 to 7 days. I hope all is well. We had Abdominal USG as well which came out to be all Clear.
As per Joea , Cytology is accurate in case of HG bladder tumors.
Hi Bills, it is good to know that your dad is doing well.
I have never heard of M-cells. Do you mean cells in mucosa layer (epithelial layer) of the bladder?
I recall that you dad was diagnosed with a single TaHG, with 20% high grade cells rate, with clinical size of > 3cm.
It is difficult for a urologist cannot detect tumor which is less than 2 mm. The size of epithelial cell is bout 20 micron or 0.02mm.
A cytopathologist uses x200 - x 400 times microscope, so they can see individual cells and counts how many cells look abnormal.
Cytology is non-invasive and accurate enough in detecting high grade urothelial carcinoma ( that is what your dad was diagnosed initially). We can consider one of main roles of cytology is to detect recurrence during the treatment for high grade bladder cancer.
It is pretty accurate for detecting high grade bladder cancer. I know a well known urologist always do cytology after cystoscopy for high grade patients. The urologist said if it is negative, then it is almost sure that no cancer. If cytology is positive even the cystoscopy sees negative, then the urologist has to look for the reason further. In this sense, your urologist recommendation for cytology is inline with the practice by other urologists. Below are some information about accuracy of cytology. best
Cytology as well as other urine analysis, eg. FISH or CxBladder are not good at detecting low grade. But they are
good at detecting high grade and CIS. In 2013, international cytopathologists/ urologists came up with Paris Reporting System (PRS)
to define the role of cytology and to improve the accuracy for reporting. Below are the categories of the report. Cytologists consider the goal of cytology is to detect high grade urothelial carcinoma because that can be life threatening. The problem in the past was that there were many cases of Atypical which means not sure. According to a single institution study of more than 27,000 cases, Atypical cases reduced from 29% pre PRS to just 6.2% post PRS. After PRS, accuracy of detecting high grade urothelial carcinoma is 90% ( Sensitivity 83%, Selectivity 91%).
For high grade urothelial carcinoma, a cell is considered as abnormal if the size of nucleus occupies 70% of the cell, or the shape / inside of the cell look bad. If numbers of abnormal cells are greater than 5, it is considered as high grade.
Hope you are are well and doing great. I had an appointment with our Uro as a general checkup and part of surveillance with blood reports and USG report. All clear till now.
While discussing the future plan , Cystoscopy and then decide on BCG maintenance dosage. Uro also suggested to go with Urine Cytology for M-Cells.
I had heard lots about this tests and many times I heard is unreliable and false positives. Can anyone suggest me more insights.