2008 Summer Meeting - Leeds - The Pathological Society of Great ...

P83Adenocarcinoma Arising in an Endocervicosis of the UrinaryBladderM Nakaguro 1 ,YSuzuki 1 ,KOno 11 Tosei General Hospital, Seto, JapanEndocervicosis is a non-neoplastic lesion exhibiting mullerian differentiation. Amalignant tumour arising in endocervicosis has not been reported, except for acase of adenocarcinoma originating from a lesion of the vagina.Herein, we describe a case of adenocarcinoma arising in endocervicosis of theurinary bladder. The patient is a 58-year-old woman. She had a history ofendometriosis, for which a total hysterectomy was performed 16 yearspreviously. Cystoscopy revealed an elevated nodular mass, 4*4 cm in size, inthe triangle area. Total cystectomy was performed. The tumour was composedof two different histological components. The dominant component wasproliferation of multiple cystic glands lined with cuboidal epithelium. Thelining epithelium had clear cytoplasm, which resembled an endocervical gland.The other histological component was proliferation of atypical cells with largenuclei, which infiltrated the surrounding connective tissue. This histologicalfinding was the same as the biopsy specimen taken previously. From thesefindings, we suggest that this is the first case of adenocarcinoma arising inendocervicosis of the urinary bladder.To determine the histochemical nature of the mucus of this tumour, weperformed various histochemical stainings, including Alcian Blue (AB)-PAS,High iron diamine (HID)-AB. We then compared the results with four controlpopulations (normal cervical gland, normal endometrial gland, adenocarcinomaof cervix, adenocarcinoma of endometrium). It is difficult to differentiate thesegroups based only on their staining characteristics, but endocervicosis is shownto have a similar histochemical nature to a normal endocervical gland.P85The role of urine cytology in the diagnosis of bladder cancer atUniversity College London Hospitals during one yearM Ben-Gashir 1 ,MFalzon 1 , A Capitanio 11 University College London HospitalsWe have seen an increase in the number of urine specimens for cytologicalexamination in our department derived from a wide range of clinicalspecialities. We audited the number of urine cytology specimens received overone year (1st December 2006 to 30th November 2007) to determine the abilityof a urine examination to diagnosis cancer.In total we found 1522 urine cytology specimens had been reported during thisyear. A histology report was found in relation to 216 (24%) specimens. Out ofthese 216 histology reports, 113 (52%) were biopsies from bladder, prostate,kidney, ureter and urethra (urology) of which 82 (73%) were bladder biopsies.A histological diagnosis of papillary TCC was made in 50 and a TCC (NOS) in10 reports.The cytological and histological diagnoses were categorized into threecategories; cancer, atypia and no malignancy.There was a complete agreement in 8 cases of cancer and 22 cases of nomalignancy.In 11 cases atypia was reported cytologically and TCC was reported inhistology.In 41 (50%) samples, no evidence of malignancy on cytology but a carcinomawas diagnosed on histology.In summary, in our department, a cytological diagnosis of malignancy isindicative of a malignant lesion of urinary bladder but a negative cytology doesnot exclude bladder carcinoma. It is essential that clinical and radiological dataare considered in every case of a negative cytology to triage patients that wouldrequire further investigation. In addition, our laboratory exploring ways ofincreasing sensitivity without compromising the specificity.P84High-Resolution SNP-Array Analysis of Chromophobe RenalCell Carcinomas and Renal OncocytomasM Yusenko 1 ,TBoethe 2 , B Ljundberg 3 , A Geurts Van Kessel 4 ,GKovacs 1 ,RKuiper 41 University of Heidelberg, Germany, 2 University of Pecs, Hungary,3 University of Umea, Sweden, 4 University of Nijmegen, The NetherlandsBenign renal oncocytomas (RO) and chromophobe renal cell carcinomas (RCC)make up approximately 10% of renal cell tumours. The histological diagnosisremains uncertain in several cases due to their overlapping phenotype.Previously, we have detected complex losses of whole chromosomes 1, 2, 6, 10,13, 17 and 21 in 70%-90% of chRCCs, whereas the loss of chromosomes 1 and14 and the Y chromosome or translocation between chromosome 11q13 andanother chromosomes or random genetic changes have been described in ROs.Now, we applied a high density 250 K SNP oligoarray to detect loss of smallDNA segments at specific chromosomal regions in chromophobe RCCs andROs, which may mark the loci of genes involved in the tumorigenesis. We havedetected several genetic alterations up to 1Mb in size in both types of tumours,most of them occurring only in a single case. Although, we failed to achieve ourgoal of identifying tumour suppressor gene loci, we have confirmed that theloss of chromosomes 2, 13, 17 and 21 occurs exclusively in chromophobeRCCs and therefore, the complex loss of these chromosomes can be used forthe differential diagnosis in cases with overlapping phenotype. As we used ahigh density array for analysing an appropriate number of cases, we canexclude the posibility of the presence of recurrent snall genetic alterations inthese two types of renal cancers.P86Analysis of the Appropriateness of Urine Cytology SpecimensR Brannan 1 , G Rodrigues 21 Department of Histopathology, Bexley Wing, St James' UniversityHospital, Leeds, 2 Department of Histopathology, Hull Royal Infirmary,HullUrine specimens are commonly sent for cytological examination. There aresome valid indications for this such as follow up of previous urothelialneoplasia. Unfortunately, some specimens are sent for inappropriate clinicalreasons creating unnecessary work for laboratory staff, cytopathologists andsecretarial staff. We conducted an audit of urine cytology specimens received inour department to determine the proportion of cases sent for inappropriateclinical indications with a final aim of producing guidelines outlining theappropriate indications for urine cytology requests.Twenty two percent of the specimens were sent for follow up of urothelialneoplasia, 39% were sent for haematuria, 15% were sent as “? malignancy” and24% were sent for a range of miscellaneous reasons including infectivesymptoms, chest pain and vomiting. One percent of all the specimens hadmalignant cytology and 10% had atypical cytology. All of these malignant andatypical cases were sent for follow up of previous neoplasia or as part of theinvestigation of haematuria.We conclude that outside of the setting of follow up and haematuria, thereis a strong argument that urine specimens should not be routinely sent forcytological examination. If this had been done during this audit period, no casesof neoplasia would have been missed and there would have been an 40%reduction in the number of specimens saving time and money.Summer Meeting (194 th ) 1–4 July 2008 Scientific Programme53