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Adequacy of Urine Specimens (Adequacy)

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The Paris System for Reporting Urinary Cytology

Abstract

Adequacy is a source of disagreement and controversy in cytopathology, and urinary tract specimens are no exception. For the purposes of this chapter, the term “adequacy” for urinary tract specimens is used to refer to the usefulness of the specimen to diagnose or raise suspicion for high-grade urothelial carcinoma (HGUC). As such, adequacy of urinary tract specimens for the diagnosis of HGUC is determined by the interplay of four specimen characteristics: collection type, cellularity, volume, and cytomorphological findings. In this chapter, we provide an algorithm for how these variables should be used to arrive at a systematic adequacy determination, review the available literature, provide recommendations for voided urinary sample volume, and build the framework for future investigations into the adequacy of urinary specimens.

Background

In the reporting of cytologic samples, a statement of adequacy provides the clinician and pathologist confidence that the specimen is representative of the target site or lesion. Defining adequacy is controversial in all areas of cytopathology, and urinary tract cytology is no exception. For the purposes of this chapter, the term “adequacy” for urine specimens is used to refer to the usefulness of the specimen to diagnose or raise the suspicion for high-grade urothelial carcinoma (HGUC). The adequacy of urine specimens for the diagnosis of urothelial carcinoma is determined by the interplay of four specimen characteristics: collection type, cellularity, volume, and cytomorphological findings. The Paris System for Reporting Urinary Cytology (TPS) provides an algorithm for how these variables should be used to arrive at a systematic adequacy determination and to provide a framework for further investigations into the adequacy of urinary cytology specimens.

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References

  1. Olson MT, Boonyaarunnate T, Aragon-Han P, Umbricht CB, Ali SZ, Zeiger MA. A tertiary center’s experience with second review of 3885 thyroid cytopathology specimens. J Clin Endocrinol Metab. 2013;98:1450–7.

    Article  CAS  Google Scholar 

  2. Barkan GA, Tabatabai ZL, Kurtycz DFI, Padmanabhan V, Souers RJ, Nayar R, Sturgis CD. Practice patterns in urinary cytopathology prior to The Paris System for Reporting Urinary Cytology. Arch Pathol Lab Med. 2020;144(2):172–6.

    Article  Google Scholar 

  3. Kurtycz DFI, Brimo F, Rosenthal DL, Siddiqui MT, Tabatabai ZL, VandenBussche CJ, Wojcik EM, Barkan GA. Perceptions of Paris: an international survey in preparation for The Paris System for Reporting Urinary Cytology 2.0 (TPS 2.0). J Am Soc Cytopathol. 2021;10(5):S4 (PL06).

    Google Scholar 

  4. VandenBussche CJ, Rosenthal DL, Olson MT. Adequacy in voided urine cytology specimens: the role of volume and a repeat void upon predictive values for high-grade urothelial carcinoma. Cancer Cytopathol. 2016;124:174–80.

    Article  Google Scholar 

  5. Rezaee N, Tabatabai ZL, Olson MT. Adequacy of voided urine specimens prepared by ThinPrep and evaluated using The Paris System for Reporting Urinary Cytology. J Am Soc Cytopathol. 2017;6:155–61.

    Article  Google Scholar 

  6. Renshaw AA, Gould E. Adequacy criteria for voided urine cytology using cytospin preparations. Cancer Cytopathol. 2019;127:116–9.

    Article  CAS  Google Scholar 

  7. Swiderek J, Morcos S, Donthireddy V, Surapaneni R, Jackson-Thompson V, Schultz L, et al. Prospective study to determine the volume of pleural fluid required to diagnose malignancy. Chest. 2010;137:68–73.

    Article  Google Scholar 

  8. Rooper LM, Ali SZ, Olson MT. A minimum fluid volume of 75 mL is needed to ensure adequacy in a pleural effusion: a retrospective analysis of 2540 cases. Cancer Cytopathol. 2014;122:657–65.

    Article  Google Scholar 

  9. Xing J, Yan Q, Monaco SE, Pantanowitz L. Determination of appropriate urine volume cutoff values for voided urine specimens to assess adequacy. J Am Soc Cytopathol. 2019;8:89–94.

    Google Scholar 

  10. Renshaw AA, Gould EW. Evidence-based adequacy criteria for instrumented urine cytology using cytospin preparations. Diagn Cytopathol. 2018;46:520–1.

    Article  Google Scholar 

  11. Barkan GA, Tabatabai ZL, Sturgis C, Kurtycz DF, Souers RJ, Nayar R. In preparation for The Paris System for Reporting Urinary Tract Cytopathology (TPSRUTC): observations from the 2014 supplemental questionnaire of the College of American Pathologists (CAP) Cytopathology Interlaboratory Comparison Program (CICP) (abstract). Lab Investig. 2015;95(Suppl 1):83A.

    Google Scholar 

  12. Murphy WM, Crabtree WN, Jukkola AF, Soloway MS. The diagnostic value of urine versus bladder washing in patients with bladder cancer. J Urol. 1981;126:320–2.

    Article  CAS  Google Scholar 

  13. Studeman KD, Ioffe OB, Puszkiewicz J, Sauvegeot J, Henry MR. Effect of cellularity on the sensitivity of detecting squamous lesions in liquid-based cervical cytolog. Acta Cytol. 2003;47:605–10.

    Article  Google Scholar 

  14. Michael CW, Pang Y, Pu RT, Hasteh F, Griffith KA. Cellular adequacy for thyroid aspirates prepared by ThinPrep: how many cells are needed? Diagn Cytopathol. 2007;35:792–7.

    Article  Google Scholar 

  15. Bastacky S, Ibrahim S, Wilczynski SP, Murphy WM. The accuracy of urinary cytology in daily practice. Cancer. 1999;87:118–28.

    Article  CAS  Google Scholar 

  16. Layfield LJ, Elsheikh TM, Fili A, Nayar R, Shidham V. Papanicolaou Society of Cytopathology. Review of the state of the art and recommendations of the Papanicolaou Society of Cytopathology for urinary cytology procedures and reporting: the Papanicolaou Society of Cytopathology Practice Guidelines Task Force. Diagn Cytopathol. 2004;30:24–30.

    Article  Google Scholar 

  17. Prather J, Arville B, Chatt G, Pambuccian SE, Wojcik EM, Quek ML, Barkan GA. Evidence- based adequacy criteria for urinary bladder barbotage cytology. J Am Soc Cytopathol. 2015;4:57–62.

    Article  Google Scholar 

  18. Richardson CJ, Pambuccian SE, Barkan GA. Split-sample comparison of urothelial cells in ThinPrep and cytospin preparations in urinary cytology: do we need to adjust The Paris System for Reporting Urinary Cytology criteria? Cancer Cytopathol. 2020;128:119–25.

    Google Scholar 

  19. Barkan GA. Enough is enough: adequacy of voided urine cytology. Cancer Cytopathol. 2015;124:163–6.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Pathology, University of California, San Francisco (UCSF), San Francisco, CA, USA

    Z. Laura Tabatabai

  2. Department of Pathology, Loyola University Healthcare System, Maywood, IL, USA

    Güliz A. Barkan

  3. Department of Cytology and Pathology, Toulouse University Hospital, Toulouse, France

    Monique Courtade-Saïdi

  4. Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Wisconsin State Laboratory of Hygiene, Madison, WI, USA

    Daniel F. I. Kurtycz

  5. Roche Tissue Diagnostics, Tucson, AZ, USA

    Matthew T. Olson

  6. Department of Pathology, Aichi Medical University Hospital, Nagakute, Aichi, Japan

    Toyonori Tsuzuki

  7. Department of Pathology/Cytopathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Christopher J. VandenBussche

  8. Department of Pathology, University of California, San Francisco (UCSF), San Francisco, CA, USA

    Poonam Vohra

Authors
  1. Z. Laura Tabatabai
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  2. Güliz A. Barkan
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  3. Monique Courtade-Saïdi
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  4. Daniel F. I. Kurtycz
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  5. Matthew T. Olson
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  6. Toyonori Tsuzuki
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  7. Christopher J. VandenBussche
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  8. Poonam Vohra
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Corresponding author

Correspondence to Z. Laura Tabatabai .

Editor information

Editors and Affiliations

  1. Department of Pathology, Loyola University Medical Center, Maywood, IL, USA

    Eva M. Wojcik

  2. Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Wisconsin State Laboratory of Hygiene, Madison, WI, USA

    Daniel F.I. Kurtycz

  3. Department of Pathology/Cytopathology, The Johns Hopkins University, Baltimore, MD, USA

    Dorothy L. Rosenthal

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Tabatabai, Z.L. et al. (2022). Adequacy of Urine Specimens (Adequacy). In: Wojcik, E.M., Kurtycz, D.F., Rosenthal, D.L. (eds) The Paris System for Reporting Urinary Cytology. Springer, Cham. https://doi.org/10.1007/978-3-030-88686-8_2

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  • DOI: https://doi.org/10.1007/978-3-030-88686-8_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-88685-1

  • Online ISBN: 978-3-030-88686-8

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