Reactive Urothelial Changes
Rose Anton, MD
Key Facts
Terminology
Most commonly seen reactive changes are secondary to stones, instrumentation, &/or radiation/chemotherapy
Cytopathology
Stones &/or instrumentation procedure
Cellular; papillary groups, often numerous with small, round, centrally placed nuclei with minimal atypical features
Radiation/chemotherapy
Bizarre cells
Large nuclei but normal N:C ratios, vacuoles, polychromasia
Top Differential Diagnoses
Urothelial carcinoma
Demonstrates more single cells, higher N:C ratios, and greater degree of nuclear membrane and chromatin irregularity
 Urolithiasis: (A) Pap stain shows cellular specimens. The urothelial cells often appear in large cohesive papillary clusters  . (B) Numerous papillary clusters are present on Pap stain. No atypical single cells with high nuclear:cytoplasmic ratios are seen in the background. (C) The nuclei are centrally placed and show bland, even chromatin on this Pap stain. (D) There is no irregular chromatin or nuclear membranes on this Pap stain. Ample cytoplasm is seen. No single atypical cells are present in the background. |
TERMINOLOGY
Definitions
Most commonly seen reactive changes are secondary to stones, instrumentation, &/or radiation/chemotherapy
CYTOPATHOLOGY
