Squamous Cell Carcinoma of Urinary Bladder
Rose Anton, MD
Nour Sneige, MD
Key Facts
Clinical Issues
Varies with geographic region (incidence higher in areas of endemic schistosomiasis)
Hematuria
Radical cystectomy is standard therapy
Cytopathology
Hyperchromasia and pleomorphism
Irregular, often sharply angulated nuclear shapes
May show prominent nucleoli
Most squamous carcinomas are keratinizing, so the cytoplasm is often orangeophilic and dense
Top Differential Diagnoses
Invasive urothelial carcinoma with squamous differentiation
Metastatic or secondary squamous cell carcinoma: In women, consider cervical primary; high-risk HPV positive by in situ hybridization
Condyloma: Look for koilocytes and low N:C ratios
 Squamous cell carcinoma: (A) These Pap-stained cells show hyperchromasia and angular nuclear membranes. The cytoplasm is densely orangeophilic. (B) Pap-stained cell  demonstrates nuclear hyperchromasia and dense cytoplasm. (C) This markedly atypical cell  shows nuclear hyperchromasia with sharp angulation of the nucleus on Pap stain. Squamous metaplasia: (D) In contrast, squamous metaplasia, as seen on this Pap stain, shows no atypical nuclear features. The nuclei are round and regular without irregular chromatin or irregular nuclear membranes. The N:C ratio is not increased. |
TERMINOLOGY
Abbreviations
Squamous cell carcinoma (SCC)
