An appraisal of urine cytology in the diagnosis of transitional cell carcinoma of the urinary bladder

Urine cytology has an acceptable sensitivity, and specificity that justifies its use in the current diagnostic protocol. In Iraq transitional cell carcinoma [TCC] constitute about 62.1% of bladder cancer [which ranks the third according to the results of Iraqi Cancer Registry 1995-1997]. Urine cytology used in the primary diagnosis, follow up, and in the screening programs of asymptomatic but high-risk patients. This study was conducted on 93 patients, diagnosed or clinically suspected to have TCC of the urinary bladder attending to the Urological department in AL-Kadhimiya Teaching Hospital, AL-Yarmouk Teaching Hospital, and Baghdad Medical City. During the period from July 2004 to July 2005. 76 were males and 17 were females. Urine cytological examination was done to those patients using two types of stain hematoxylin and eosin, and papanicoloau stain] to detect malignant cells with the identification of the degree of differentiation, if possible, the cytological findings were correlated with the hisiopathological findings. And the cytological findings compared regarding each type of stain. Mean age of the patients was 59 year. Male.female ratio was 4.4:1. Main clinical presentation was hematuria [45.8%] of the total. Urine cytological examination has a sensitivity of 87.7%, specificity of 100% with an overall accuracy of 78% in the detection of TCC of urinary bladder. The main chief complaint of patients with TCC was haematuriawitch constitute 45.8% of the total. The percentage of highgrade cases in urine cytology was higher than that in histopathology.the percentage of cases of TCC diagnosed by papanicoloau stain was more than that diagnosed by II and E [73.24% by pap stain versus 70.42% by H and E]. Urine cytology has an acceptable sensitivity, specificity and an overall accuracy in the diagnosis of TCC of urinary bladder, and it offers a good chance for determination of the grade of the tumor especially in high grade tumor. Pap stain was better in the diagnosis of TCC

Epithelial cytological atypia associated with intrauterine contraceptive devices

Prolonged usage of an intrauterine contraceptive device [IUD] is often associated with exfoliation of atypical cells. These cells are commonly observed in gynecologic preparations and can cause considerable difficulty in their interpretation; misdiagnosed to represent adenocarcinoma, epidermoid carcinoma, or other dysplastic lesions. The study was conducted at AL-Kadhimiya Teaching Hospital from September 2003 till June 2005. Fifty PAP smears with atypical cells from women wearing IUD were examined cytologically. The age range was 18-42 with average age of 29 years. Ten had at least one previous smear from a period of three months to 5 years, the most common cause of IUCD removal were menstrual disorders. The cases were categorized cytologically into two groups: the first consisted of nine cases consider to represent atypia of reparafive nature resulting from inflammation or infection, the remaining 41 cases of the second group fell into three subgroups: squamous, columnar, and indeterminate type of atypia. Columnar atypia is characterized by abnormal cells which can resemble cells from carcinoma in situ. Unlike the latter the atypical cells from IUD are usually multinucleated contain nucleoli, and are not associated with cells from severe cervical atypia. They are probably endometrial in origin. There is no likelihood of an enhanced incidence of cervical dysplasia or carcinoma, however an awareness of IUCD associated cytomorphological alterations to avoid wrong diagnoses of carcinoma. In every smear with columnar and/or indeterminate atypia in reproductive age group women, the patient should be asked if she wear an IUD to avoid wrong diagnosis of carcinoma

evaluation of methods of inducing sputum production in patient with suspected lung cancer

The major focus of respiratory cytology is the diagnosis of lung cancer, carcinoma of the lung is now reported to be the most commonly diagnosed non- Cutaneous malignancy in the world. Iraq has faced the increase in incidence of this lethal type of cancer. Sputum cytology is a convenient method of screening and diagnosing primary epithelial tumor of the lung which is of many types include fresh smear, Sacccomanno smear, and mailing container method. Sputum cytological study was done on 50 patients suspected to have pulmonary carcinoma prepared by fresh smear method, Saccomanno method, and mailing container method. One, two, or three samples taken from each patient. Slides were prepared and stained by H and E stain and examined thoroughly. The accuracy specificity, and sensitivity was found for each method for comparison. A careful and sometimes frequent sputum samples is very essential in the diagnosis of lung cancer. Preservation and fixation methods are found to facilitate more accurate diagnosis especially in areas far from hospital