3. VOIDED URINE
Simplest method of collection.
Early morning urine should be avoided because of the poor
morphological details shown by the cells exfoliated during
the night and being exposed to urine for several hours.
The best is a mid-morning ambulatory specimen.
The sample should be sent to the laboratory as soon as
possible.
If a short delay is inevitable the container should be kept in
a refrigerator.
In case of longer delay some alcohol should be added to
the sample.
4. CATHETER SPECIMENS
This method facilitates the collection of good samples without
contamination.
The method of choice when urine must be collected from one
of ureters.
The disadvantages are that it is an invasive procedure with the
possibility of detaching sheets of urothelial cells with the tip
of the catheter.
These cells can mimic cells from a papillary tumour
cytologically.
5. BLADDER WASHINGS
This is also known as barbotage.
It is performed by irrigating the bladder with a saline
or fixative solution.
It has the same disadvantages of catheter specimens,
but the cellularity obtained and the cell preservation
are very good and superior to voided urine.
6. PREPARATION OF SPECIMEN
• Esposito’s fixative
• Cytocentrifugation
• Direct smear
• Membrane filter preparations
• Monolayer preparations
7. ESPOSITO'S FIXATIVE
Good fixative fluid for bladder washing .
100 ml of Esposito's fixative contains 10 ml of acetic acid,
45 ml of methanol and 45 ml of deionizer water.
The fluid is used to irrigate the bladder, collected in a 250
ml bottle and then sent to the laboratory.
It is centrifuged to obtain a pellet, the supernatant discarded
and 2 drops of pectin added to the pellet to facilitate
detachment from the centrifuge tube wall.
Finally two drops from the cell pellet are placed on a
microscope slide, air-dried at room temperature and stained
according to the Papanicolaou method.
Two or more slides are prepared for each case.
8. OTHER PREPARATION
TECHNIQUES
• Centrifugation followed by Cytocentrifugation.
– Alcohol fixation is necessary before staining with the
Papanicolaou method.
– Cytocentrifugation should produce a sample which is almost a
monolayer of cells measuring about 6 mm in diameter.
• Direct smears
– They are easier to prepare but show usually scanty cellularity.
9. • Membrane filter preparations:
– They show very good cellularity, but are difficult to
prepare.
– Preparations are fixed in alcohol and stained using the
Papanicolaou stain.
• Monolayer preparations such as Thin Prep
– Preservation of the cells - very good
– Procedure is easier than the filter method.
– Expensive
10. Urinary Tract Histology
Superficial cell layer :
• one cell thick, superficial squames-size or larger,
multinucleated
Intermediate cell layer :
• approximately 5 cell layers, parabasal-size cells
Basal cell layer :
• one cell thick, cuboidal-columnar
12. UPPER URINARY TRACT
HISTOLOGY
URETER AND
RENAL PELVIS
• Lining cells are
larger and more
pleomorphic than
bladder (decreased
cell turnover &
exfoliation).
13. NORMAL URINARY TRACT
CYTOLOGY
SUPERFICIAL UROTHELIAL CELLS
• Marked variation in size and
shape (10-150 u), low N/C
• Often polygonal
• Abundant pale cytoplasm,
well defined borders
• Occasional vacuolization
• Round-oval nuclei, often
multinucleated
14. NORMAL URINARY TRACT
CYTOLOGY
DEEP UROTHELIAL CELLS
• Uniform in shape and
size (10-20 u)
• Scant to moderate
dense cytoplasm,
distinct borders, fine
vacuolization
• Central nuclei, finely
granular chromatin,
small nucleoli
15. Voided Urine Is Sparsely Cellular, Single
Cells-degeneration
