TY - JOUR
T1 - Spindling artifact of urothelial cells in post‐laser treatment urinary cytology
AU - Fanning, Christina V.
AU - Staerkel, Gregg A.
AU - Sneige, Nour
AU - Thomsen, Sharon
AU - Myhre, Michael J.
AU - von Eschenbach, Andrew C.
PY - 1993/5
Y1 - 1993/5
N2 - We reviewed 22 post‐laser (Nd:YAG laser) coagulation bladder washes collected immediately after treatment. All washes demonstrated a striking artifact of cellular spindling. These spindled cells occurred singly, in loose clusters, and in lamellar stacks and had elongated nuclei with dense chromatin and bipolar cytoplasm that was fused in the stacks. Concurrent biopsies demonstrated similar cytologic changes. The spindling is a nonspecific epithelial response to heat. Conventionally electrocauterized epithelia show this artifact in biopsies, but since only the base of the lesion and surrounding urothelium are subjected to heat with electrocautery, the relatively few spindled epithelial cells created presumably go undetected in cytology specimens. With laser treatment, however, the whole urothelial surface of the lesion is coagulated, producing a much greater number of spindled cells. It is important to avoid misinterpreting the spindled cells as cells from a mesenchymal neoplasm or a sarcomatoid carcinoma, mistakes that were made in some of our initial cases. Malignancy cannot be evaluated when cells exhibit spindling artifact; this judgement should be made on undistorted cells. Thus, pre‐laser and post‐laser washes should be submitted for evaluation of malignancy.
AB - We reviewed 22 post‐laser (Nd:YAG laser) coagulation bladder washes collected immediately after treatment. All washes demonstrated a striking artifact of cellular spindling. These spindled cells occurred singly, in loose clusters, and in lamellar stacks and had elongated nuclei with dense chromatin and bipolar cytoplasm that was fused in the stacks. Concurrent biopsies demonstrated similar cytologic changes. The spindling is a nonspecific epithelial response to heat. Conventionally electrocauterized epithelia show this artifact in biopsies, but since only the base of the lesion and surrounding urothelium are subjected to heat with electrocautery, the relatively few spindled epithelial cells created presumably go undetected in cytology specimens. With laser treatment, however, the whole urothelial surface of the lesion is coagulated, producing a much greater number of spindled cells. It is important to avoid misinterpreting the spindled cells as cells from a mesenchymal neoplasm or a sarcomatoid carcinoma, mistakes that were made in some of our initial cases. Malignancy cannot be evaluated when cells exhibit spindling artifact; this judgement should be made on undistorted cells. Thus, pre‐laser and post‐laser washes should be submitted for evaluation of malignancy.
KW - Bladder washings
KW - Cellular spindling
KW - Laser effect
KW - Transitional cell carcinoma
KW - Urinary cytology
UR - http://www.scopus.com/inward/record.url?scp=0027173890&partnerID=8YFLogxK
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U2 - 10.1002/dc.2840090307
DO - 10.1002/dc.2840090307
M3 - Article
C2 - 7632179
AN - SCOPUS:0027173890
SN - 8755-1039
VL - 9
SP - 279
EP - 281
JO - Diagnostic Cytopathology
JF - Diagnostic Cytopathology
IS - 3
ER -