Fig. 4
Suspicious for high-grade urothelial carcinoma (bladder washing, ThinPrep, Papanicolaou stain, 600×). This urine specimen contains rare cells with high N/C ratio (>0.7), irregular nuclear contours, and coarse chromatin. Compared with the benign urothelial cells, the abnormal urothelial cells are hyperchromatic and are all features of HGUC; however, the paucity of abnormal urothelial cells (arrows) precludes a definitive diagnosis of HGUC. On follow-up this patient had invasive HGUC in the urinary bladder.