No abstract available.
Carcinoma, Transitional Cell* ; Diagnosis* ; Kidney*

No abstract available.
Carcinoma, Transitional Cell* ; Diagnosis* ; Urinary Bladder*

Urinary cytology is increasingly accepted as a diagnostic tool in the detection and follow-up of patients with bladder cancer. However, its value is reduced by several limitations, especially by the tack of cytologic criteria specifically reflecting the morphology of low-grade urothelial neoplasm. We reviewed histologically proven 50 cases of urine cytology with emphasis on cytologic findings of benign atypia and differential findings of urothelial neoplasm according to the grade. The diagnoses included 17 benign lesions (including 5 cases of urine calculi) and 33 malignant lesions(including 28 transitional cell carcinomas. 3 squamous cell carcinomas, 1 adenocarcinoma and 1 prostate adenocarcinoma). Diagnostic accuracy was 92%. Important cytodiagnostic criteria for benign atypia and low grade malignancy were cellularity, number of cell clusters, and morphology and arrangement of urothelial cells. The cytologic findings of urothelial neoplasms according to histologic grade were relatively well correlated with the histologic findings. However, the cytologic criteria were not sufficient to readily distinguish grade I from grade II. In view of this, we think that cytologic nomenclature "low-grade" and "high-grade" is a more reliable criterion. Recognition of subtle cellular morphologic features specific for urothelial lesions(including benign or malignancy) and proper fixation, processing and staining of specimen can expand the role of urinary cytology in detection and follow-up of patients.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell ; Diagnosis ; Humans ; Prostate ; Urinary Bladder Neoplasms

We report a case of primary transitional cell carcinoma developed in bladder vdiverticulum with brief review of literatures. Patient was a 71 year-old man who had painless gross hematuria for 10 days. Excretory urogram showe a large diverticulum in the bladder. At cystoscopy a 0.5 x 0.5cm sized papillary mass was seen on diverticular mucosa. Urine cytology revealed class V transitional cell carcinoma. At pelvic CT, metastatic evidence was not seen. We carried out partial cystectomy involving diverticulum under the diagnosis of primary transitional cell carcinoma developed in vesical diverticulum. The histopathologic diagnosis was grade III, stage A transitional cell carcinoma combining with carcinoma in situ.
Aged ; Carcinoma in Situ ; Carcinoma, Transitional Cell* ; Cystectomy ; Cystoscopy ; Diagnosis ; Diverticulum* ; Hematuria ; Humans ; Mucous Membrane ; Urinary Bladder*

PURPOSE: There is no reliable method for predicting which patient with a T1G3 bladder tumor will progress and possibly benefit from an early cystectomy. The prognostic significance of p53, pRb, and p21(waf1) expression was evaluated in patients with a T1G3 bladder tumor. MATERIALS AND METHODS: Of the 787 patients with a newly diagnosed bladder tumor, 485 were superficial. Of these patients, 57 had a T1G3 transitional cell carcinoma. Overall, a total of 30 patients were included in this study. A tumor with nuclei staining more than 10% with either p53 or p21(waf1) antibodies were defined as having altered p53 or p21(waf1) expression. The relationship between recurrence and progression and the results of immunostaining in a T1G3 bladder cancer was analyzed. RESULTS: A pathological diagnosis consisted of 14 papillary and 16 non-papillary including 2 mixed transitional cell cancers. An associated carcinoma in situ was noted in 3 patients. Of the 30 patients, 11 had a recurrence. A progression to muscle invasive bladder cancer had developed in 6 cases at a mean interval of 10.2 months. Each separate expression of p53, p21(waf1) and pRb did not correlate with tumor recurrence or progression. However, patients with combination of a positive p53 with a negative p21(waf1) and a negative pRb test had a significantly higher rate of progression to muscle invasive disease. CONCLUSIONS: A combination of altered immunostaining for a positive p53 with a negative p21(waf1) and a negative pRb test correlated with progression of a T1G3 TCCa of the bladder but not with a recurrence. Therefore, early cystectomy should be considered in a T1G3 bladder tumor with an altered expression of p53 with either p21(waf1) or with pRb.
Antibodies ; Carcinoma in Situ ; Carcinoma, Transitional Cell ; Cystectomy ; Diagnosis ; Humans ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: There is no reliable method for predicting which patient with a T1G3 bladder tumor will progress and possibly benefit from an early cystectomy. The prognostic significance of p53, pRb, and p21(waf1) expression was evaluated in patients with a T1G3 bladder tumor. MATERIALS AND METHODS: Of the 787 patients with a newly diagnosed bladder tumor, 485 were superficial. Of these patients, 57 had a T1G3 transitional cell carcinoma. Overall, a total of 30 patients were included in this study. A tumor with nuclei staining more than 10% with either p53 or p21(waf1) antibodies were defined as having altered p53 or p21(waf1) expression. The relationship between recurrence and progression and the results of immunostaining in a T1G3 bladder cancer was analyzed. RESULTS: A pathological diagnosis consisted of 14 papillary and 16 non-papillary including 2 mixed transitional cell cancers. An associated carcinoma in situ was noted in 3 patients. Of the 30 patients, 11 had a recurrence. A progression to muscle invasive bladder cancer had developed in 6 cases at a mean interval of 10.2 months. Each separate expression of p53, p21(waf1) and pRb did not correlate with tumor recurrence or progression. However, patients with combination of a positive p53 with a negative p21(waf1) and a negative pRb test had a significantly higher rate of progression to muscle invasive disease. CONCLUSIONS: A combination of altered immunostaining for a positive p53 with a negative p21(waf1) and a negative pRb test correlated with progression of a T1G3 TCCa of the bladder but not with a recurrence. Therefore, early cystectomy should be considered in a T1G3 bladder tumor with an altered expression of p53 with either p21(waf1) or with pRb.
Antibodies ; Carcinoma in Situ ; Carcinoma, Transitional Cell ; Cystectomy ; Diagnosis ; Humans ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: To assess the utility of multiphasic spiral CT for characterizing renal masses. MATERIALS AND METHODS: The study included 36 patients (53 lesions) referred for the evaluation of renal masses suspected on the basis of the results of sonography or radiography. Spiral CT of the kidneys was performed prior to and following power injection of intravenous contrast material (Optiray-320). Postcontrast imaging data were obtained and analyzed during early and late corticomedullary (20-30-second delay), nephrographic (60-70-second delay), and excretory (5-minute delay) phases. During each phase, the ability to detect renal masses was evaluated, and the ability to diagnose these masses on routine and multiphasic CT was assessed. Routine precontrast and excretory phase CT studies were performed and the usefulness of each phase for the diagnosis of renal cell carcinoma (RCC) and transitional cell carcinoma (TCC) was evaluated. RESULTS: The rates for the detection of renal masses were as follows: 94.3% on precontrast scan, 93.8% during the early corticomedulolary phase (ECMP), 98.1% during the late corticomedullary phase (LCMP), 100% during the nephrographic phase (NP), and 98.1% during the excretory phase (EP). During both routine and multiphasic CT, diagnostic accuracy was 96.2%, though for differential diagnosis, multiphasic CT was more helpful than routine CT in 4/16 cases of RCC and 2/8 cases of TCC. The highest for lesion characterization, during the LCMP in RCC, and the LCMP and NP in TCC ; for evaluation of tumor margin during the EP in both RCC and TCC ; for delineation of the renal artery, during the LCMP in both RCC and TCC ; for delineating the renal vein, during the NP in RCC, and the LCMP in TCC. CONCLUSION: For the detection and correct diagnosis oflesions, multiphasic CT was not superior to routine CT, but for the characterization of RCC and TCC, the former was helpful. The most useful phase can differ according to the kind of renal mass, and so for characterization of the mass, the most appropriate phase must be selected.
Carcinoma, Renal Cell ; Carcinoma, Transitional Cell ; Diagnosis ; Diagnosis, Differential ; Humans ; Kidney ; Radiography ; Renal Artery ; Renal Veins ; Tomography, Spiral Computed*

PURPOSE: In noninvasive tests for the diagnosis of bladder cancer, it has been reported that urine cytology has high specificity but low sensitivity. This study compared urine cytology and the urine ThinPrep(R)test, a recently introduced noninvasive test, for assessing the diagnosis of bladder cancer. MATERIALS AND METHODS: A single voided urine samples were obtained preoperatively from patients diagnosed with a transitional cell carcinoma of the bladder following a transurethral resection(TURB). The sensitivity and specificity of the urine ThinPrep(R)test was compared with the urine cytology, according to pathological stage, grade, size and number. RESULTS: In the test group(n=40), the overall sensitivity of the urine ThinPrep(R)test was 75% versus 47.5% for urine cytology(p=0.012). In the control group(n=41), the specificity of the urine ThinPrep(R)test was 97.7% versus 100% for urine cytology (p=0.314). The sensitivity of urine cytology increased with the increasing pathological stage, grade, tumor size and number. Although not significant, the sensitivity of the urine ThinPrep(R)test also increased as the grade, tumor size and number increased, but not for the pathological stage. In the <3cm, single, grade 2 and stage Ta groups the urine ThinPrep(R)test gave a significantly higher increase in the sensitivity than for the same groups by urine cytology. CONCLUSIONS: Although there was no significant increase in the sensitivity with grade 1 and stage T1, there were significant increases in the groups of stage Ta, grade 2, single and small size(<3cm) with the urine ThinPrep(R)test. Therefore it can be concluded that the urine ThinPrep(R)test has a potential to increase the sensitivity in low grade, low stage bladder cancer without loss of the high level of specificity and warrants further investigation, with more cases and controls, as an ancillary noninvasive test, with cystoscopy, in the diagnosis of bladder cancer.
Carcinoma, Transitional Cell ; Cystoscopy ; Diagnosis* ; Humans ; Sensitivity and Specificity ; Biomarkers, Tumor ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Disagreement exists about the accuracy of excretory urography in the staging of bladder cancer. During a 2O year period 1O8 of 537 patients with transitional cell carcinoma of the bladder had ureteral obstruction on excretory urography at the time of initial diagnosis. 93 patients (86%) had muscle invasion at staging transurethral resection or open resection. Of those patients 37 had total cystectomy, 4 had partial cystectomy, 5 had curative radiation therapy and the remainder had no further treatment. Ureteral obstruction at the time of initial diagnosis of bladder cancer usually indicates muscle invasion and/or metastases. We believe that our data support the usefulness of excretory urography as a staging tool in carcinoma of the bladder.
Carcinoma, Transitional Cell ; Cystectomy ; Diagnosis ; Humans ; Neoplasm Metastasis ; Ureteral Obstruction ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urography*

Although the excretory urogram, retrograde pyelogram, renal angiogram and ultrasound studies provide formidable competition in renal imaging, CT has advantages over each of these techniques and can provide unique and vital information in evaluating selected renal diseases. CT provide a cross-sectional view of the anatomy, thus delineating more clearly the renal margins and adjacent organs. CT imaging is not dependent on renal function and more easily recognized as a true anatomic portrayal, Furthermore, to discriminate density differences, the nature of renal masses may be determined. Recently we experienced several cases of renal diseases, confirmed with CT which was particuly useful in making in accurate diagnosis than other urologic examinations. Surgery, clinical follow-up and repeated radiologic examinations confirmed the accuracy of CT and there were no cases in which medical of surgical management was inappropriately guided by CT. herein a series of renal disease-polycystic kidney with bilateral radiolucent pelvic stones, angiomyolipoma, renal infarction, renal injury and renal pelvic transitional cell carcinoma were presented and the diagnostic advantages of CT for evaluation of renal diseases were discussed with a review of the literatures.
Angiomyolipoma ; Carcinoma, Transitional Cell ; Diagnosis ; Follow-Up Studies ; Infarction ; Kidney ; Ultrasonography