Effects Of Radiotherapy On Urothelial Cells

Figure 4.3. Normal Enteric and Urothelial Cells—ileal loop urine: The normal umbrella cells have well preserved nucleoli and abundant cytoplasm. They are also larger than the smaller degenerated enteric cells that resemble macrophages. (600x)

Having Sex With Illeal Loop
Figure 4.4. High Grade Urothelial Carcinoma—loop urine: Recurrent cancer presents with a variety of features, some of which are no more than cellular debris, suggesting tissue necrosis. Careful search for malignant urothelial cells is critical to render a definitive diagnosis of malignancy. (400x)

Figure 4.5. High Grade Urothelial Carcinoma—loop urine: Scattered high grade urothelial carcinoma cells are surrounded by smaller degenerated enteric epithelial cells from an ileal loop following cystectomy. Most of the cancer cells are much larger than the enteric cells. There are some tumor cells that are small but their high NC ratios and nuclear features are evidence of their malignancy. (400x)

High Grade Urothelial Cancer
Figure 4.6. High Grade Urothelial Carcinoma—loop urine: Malignant cells of varying sizes, but all with enlarged nuclei and high NC ratios, are contrasted with smaller degenerated enteric epithelial cells (^). (600x)
Urothelial Cells Urine
Figure 4.7. BCG Therapy—bladder biopsy: Conservative therapy for in situ bladder cancer usually includes a series of BCG instillations. The almost immediate cellular reaction is denudation of the mucosa and development of submucosal granulomas. (H&E, 200x)
Picture Bladder Biopsy Urothelial
Figure 4.8. BCG Therapy—bladder biopsy: A closer look at the non-caseating granulomas confirms the assortment of lymphocytes, fibroblasts and macrophages. (H&E, 400x)
Istilliation Bcg
Figure 4.9. BCG Therapy—bladder washing: Dense coagulum is a common finding following BCG instillations, and reflects the leaking of serum through the denuded urothelium. (200x)
Figure 4.10. BCG Therapy—bladder washing: Closer examination of the coagulum discloses entrapped lymphocytes. (400x)
Bcg Cytology Effects
Figure 4.11. BCG Therapy—bladder washing: Occasional multinucleated histocytes are recovered in a sample, reflecting the granulomatous process. They should not be confused with residual tumor cells that will have larger and more hyperchromatic nuclei, and higher NC ratios. (400x)
Trichomonas Vaginalis

Figure 4.12. Chemotherapy Effect—bladder washing: In this bladder washing specimen, a large atypical cell is seen in the center of the field. The cell has an enlarged nucleus with marked hyperchromasia. However, the nuclear to cytoplasmic ratio is not increased and the cytoplasm has a reparative appearance. A background of acute inflammation and benign squamous and urothelial cells is seen. This cell is representative of chemotherapy effect. (600x)

Figure 4.12. Chemotherapy Effect—bladder washing: In this bladder washing specimen, a large atypical cell is seen in the center of the field. The cell has an enlarged nucleus with marked hyperchromasia. However, the nuclear to cytoplasmic ratio is not increased and the cytoplasm has a reparative appearance. A background of acute inflammation and benign squamous and urothelial cells is seen. This cell is representative of chemotherapy effect. (600x)

Atypical Urothelial Cells

Figure 4.13. Chemotherapy Effect—bladder washing: A cluster of atypical urothelial cells is observed. These cells have a moderate amount of cytoplasm although the nuclei are slightly atypical and a binucleated cell is seen. The nuclei are round to oval. Crystals are seen in the background. This patient has a history of uterine cancer and systemic chemotherapy. (600x)

Figure 4.13. Chemotherapy Effect—bladder washing: A cluster of atypical urothelial cells is observed. These cells have a moderate amount of cytoplasm although the nuclei are slightly atypical and a binucleated cell is seen. The nuclei are round to oval. Crystals are seen in the background. This patient has a history of uterine cancer and systemic chemotherapy. (600x)

Urothelial Cells Urine

Figure 4.14. Chemotherapy Effect—catheterized urine: Acute inflammatory cells are seen with degenerated atypical urothelial cells in this patient with a history of chemotherapy. In the center field is a large binucleated urothelial cell that contains abundant cytoplasm and prominent cytoplas-mic vacuoles, although the nuclear chromatin is hyperchromatic and the nuclear membranes are irregular. The low nuclear to cytoplasmic ratio and the abundant cytoplasm indicate that the findings are most likely that of chemotherapy effect. (600x)

Figure 4.14. Chemotherapy Effect—catheterized urine: Acute inflammatory cells are seen with degenerated atypical urothelial cells in this patient with a history of chemotherapy. In the center field is a large binucleated urothelial cell that contains abundant cytoplasm and prominent cytoplas-mic vacuoles, although the nuclear chromatin is hyperchromatic and the nuclear membranes are irregular. The low nuclear to cytoplasmic ratio and the abundant cytoplasm indicate that the findings are most likely that of chemotherapy effect. (600x)

Figure 4.15. Chemotherapy Effect—bladder washing: A cluster of atypical hyperchromatic urothelial cells is seen in this patient who has a history of chemotherapy. A background of acute inflammation and benign urothe-lial cells is seen. The atypical cells exhibit irregular nuclear membranes although the nuclei are degenerated. (600x)

Mic Vacuole

Figure 4.16. Chemotherapy Effect—bladder washing: Atypical urothelial cells are admixed with acute inflammation and degenerated and benign urothelial cells. In the center of the field is a cell with abundant cytoplasm and a degenerated small hyperchromatic nucleus. Cytoplasmic tails may be seen in chemotherapy effect. (600x)

Figure 4.16. Chemotherapy Effect—bladder washing: Atypical urothelial cells are admixed with acute inflammation and degenerated and benign urothelial cells. In the center of the field is a cell with abundant cytoplasm and a degenerated small hyperchromatic nucleus. Cytoplasmic tails may be seen in chemotherapy effect. (600x)

Atypical Urothelial Cells

Figure 4.17. Radiation Effect—bladder washing: An atypical urothelial cell is seen in the bottom center field. The cell has an enlarged nucleus and a moderate amount of basophilic cytoplasm. The nucleus has a degenerated quality, and in the background, degenerated debris, crystals and benign squamous cells are seen. (600x)

Figure 4.17. Radiation Effect—bladder washing: An atypical urothelial cell is seen in the bottom center field. The cell has an enlarged nucleus and a moderate amount of basophilic cytoplasm. The nucleus has a degenerated quality, and in the background, degenerated debris, crystals and benign squamous cells are seen. (600x)

Nuclear Radiation Blood Cells Effect

Figure 4.18. Radiation Effect—bladder washing: A multinucleated atypical urothelial cell is admixed with abundant blood, debris, and neutrophils. Superficial urothelial cells may exhibit significant radiation effect, including nuclear hyperchromasia, nuclear membrane irregularities, and nuclear membrane thickening. (600x)

Figure 4.18. Radiation Effect—bladder washing: A multinucleated atypical urothelial cell is admixed with abundant blood, debris, and neutrophils. Superficial urothelial cells may exhibit significant radiation effect, including nuclear hyperchromasia, nuclear membrane irregularities, and nuclear membrane thickening. (600x)

Radiation Blood Cells

Figure 4.19. Radiation Effect—bladder washing: Atypical, degenerated urothelial cells are seen. These atypical cells exhibit a slightly increased nuclear to cytoplasmic ratio and nuclear membrane irregularities. The nuclei are slightly hyperchromatic. The cytoplasm exhibits vacuolization and degeneration, features typical of radiation effect. (600x)

Figure 4.19. Radiation Effect—bladder washing: Atypical, degenerated urothelial cells are seen. These atypical cells exhibit a slightly increased nuclear to cytoplasmic ratio and nuclear membrane irregularities. The nuclei are slightly hyperchromatic. The cytoplasm exhibits vacuolization and degeneration, features typical of radiation effect. (600x)

Figure 4.20. Radiation Effect—bladder washing: A multinucleated urothelial cell is seen in this patient who has undergone radiation treatment. The cells show multiple overlapping nuclei, as well as an eccentrically placed nucleus in the same cell. The nuclei have small nucleoli. (600x)

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