High-Grade Urothelial Carcinoma (HGUC)

Abstract

High-grade urothelial carcinoma (HGUC) is diagnosed using major criteria which include high N/C ratio, irregular nuclear membranes, and coarse chromatin. TPS second edition recognizes these criteria to be stringent in order to normalize the cytomorphologic heterogeneity of HGUC on urine samples and has included notable variances which may be present in urine samples. These variances are most notably N/C ratios that have a wide range in tumor cells and hypochromasia in select cases, along with HGUC sub-types, all of which impact cytologic interpretation. Degeneration of tumor cells also affects diagnosis of HGUC. The recognition of the major criteria and the variances will help in diagnosis of HGUC on cytologic specimens.