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Endoscopic brush cytology of the upper urinary tract. Evaluation of its efficacy and potential limitations in diagnosis.

Publication ,  Journal Article
Dodd, LG; Johnston, WW; Robertson, CN; Layfield, LJ
Published in: Acta Cytol
1997

OBJECTIVE: To evaluate the efficacy of endoscopic brush cytology in diagnosing transitional cell carcinoma of the upper urinary tract. STUDY DESIGN: Sixty-three endoscopic brush cytology specimens from 48 patients were compared with corresponding cytologic specimens obtained by irrigation and catheterization as well as histologic specimens. RESULTS: Twenty patients (25 brushes) had histologically documented transitional cell carcinoma (TCC) or carcinoma in situ (CIS) of either the ureter or renal pelvis. Among these, 8 (32%) of the brush samples were reported as positive for TCC, 10 (40%) atypical or suspicious, and 7 (28%) negative. The seven negative cases were ultimately shown to be low grade (I-II/IV) TCC. Combining atypical and positive diagnoses, the calculated sensitivity for diagnosis of TCC by this technique was 72%. The irrigations or catheterized urines from these same patients yielded lower sensitivity, 48%, and detected only higher grade lesions. Ten patients were proven histologically to have nonneoplastic disease (hydroureter, obstruction, inflammation). Sixteen of the 17 brush specimens from these patients were negative, resulting in a specificity of 94%. In the remaining 18 patients (21 brushes) there were 17 negatives and 4 atypicals. Concomitant cytology supported the brush diagnosis in all but one sample. CONCLUSION: Brush cytology is a specific and more sensitive sampling method than irrigation or catheterized urine in detecting TCC of the upper urinary tract. Brush cytology does not appear to be successful in diagnosing dysplasia or CIS. As with urinary cytology in general, the technique is less effective in diagnosing low grade (I and II) lesions.

Duke Scholars

Published In

Acta Cytol

DOI

ISSN

0001-5547

Publication Date

1997

Volume

41

Issue

2

Start / End Page

377 / 384

Location

Switzerland

Related Subject Headings

  • Ureteroscopy
  • Ureteral Neoplasms
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Pathology
  • Kidney Pelvis
  • Kidney Neoplasms
  • Humans
  • Evaluation Studies as Topic
  • Cytological Techniques
 

Citation

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MLA
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Dodd, L. G., Johnston, W. W., Robertson, C. N., & Layfield, L. J. (1997). Endoscopic brush cytology of the upper urinary tract. Evaluation of its efficacy and potential limitations in diagnosis. Acta Cytol, 41(2), 377–384. https://doi.org/10.1159/000332528
Dodd, L. G., W. W. Johnston, C. N. Robertson, and L. J. Layfield. “Endoscopic brush cytology of the upper urinary tract. Evaluation of its efficacy and potential limitations in diagnosis.Acta Cytol 41, no. 2 (1997): 377–84. https://doi.org/10.1159/000332528.
Dodd LG, Johnston WW, Robertson CN, Layfield LJ. Endoscopic brush cytology of the upper urinary tract. Evaluation of its efficacy and potential limitations in diagnosis. Acta Cytol. 1997;41(2):377–84.
Dodd, L. G., et al. “Endoscopic brush cytology of the upper urinary tract. Evaluation of its efficacy and potential limitations in diagnosis.Acta Cytol, vol. 41, no. 2, 1997, pp. 377–84. Pubmed, doi:10.1159/000332528.
Dodd LG, Johnston WW, Robertson CN, Layfield LJ. Endoscopic brush cytology of the upper urinary tract. Evaluation of its efficacy and potential limitations in diagnosis. Acta Cytol. 1997;41(2):377–384.
Journal cover image

Published In

Acta Cytol

DOI

ISSN

0001-5547

Publication Date

1997

Volume

41

Issue

2

Start / End Page

377 / 384

Location

Switzerland

Related Subject Headings

  • Ureteroscopy
  • Ureteral Neoplasms
  • Sensitivity and Specificity
  • Reproducibility of Results
  • Pathology
  • Kidney Pelvis
  • Kidney Neoplasms
  • Humans
  • Evaluation Studies as Topic
  • Cytological Techniques