XXXX of the urinary tract: a precursor lesion?

@entity1 @entity1377 @entity5 @entity2225 @entity189 @entity787 @entity876 @entity854 @entity4648 @entity2543 @entity5822 @entity1758 @entity811
BACKGROUND: @entity4648 with cytologic atypia ( @entity4648 ) is occasionally encountered and its biologic potential is uncertain. METHODS: The authors describe 18 cases of @entity4648 characterized by the presence of prominent cytologic atypia, including nuclear enlargement, nuclear hyperchromasia, and enlarged nucleoli. DNA ploidy analysis by digital image analysis and immunostaining for high-molecular-weight cytokeratin (34betaE12), @entity5822 , @entity2225 , @entity787 ( @entity787 ), @entity2543 ( @entity2543 ), @entity876 , and @entity1758 were performed in 9 cases. RESULTS: The mean @entity1 age was 62 years (median, 65 years; range, 39-84 years). The male-to-female ratio was 2.6:1. Two @entity1 had a history of noninvasive @entity1377 . The typical clinical presentation was @entity811 (8 @entity1 ) and voiding symptoms (5 @entity1 ). Cystoscopic findings were suspicious for @entity5 in 7 of 13 cases. The neoplastic cells were positive for high-molecular-weight cytokeratin, @entity5822 , and @entity2543 , and were usually negative for @entity2225 and @entity787 . @entity876 nuclear accumulation and increased @entity1758 labeling index were seen in 4 cases. DNA ploidy analysis showed aneuploid pattern in 2 of 9 cases. The mean @entity1 follow-up was 3.5 years (range, 0.5-10.6 years); 2 @entity1 had recurrent @entity4648 , and the remainder were alive without recurrence or @entity189 . CONCLUSIONS: @entity4648 is benign; it occasionally displays @entity854 of no apparent clinical significance. Awareness of the spectrum of cytologic changes within this entity is critical to prevent overdiagnosis of @entity5 and avoid unnecessary treatment. There is no direct evidence that links @entity4648 to @entity5 .
