Cytologic presentation of renal adenocarcinoma in urinary sediment.

The role of cytology in 44 cases of renal adenocarcinoma was evaluated. The diagnosis of neoplasia was made with radiographic means in all cases; urinary cytology was positive in only 19 patients (43.18%) and is therefore considered unsatisfactory in the detection of renal adenocarcinoma. The cytologic presentation of this disease was characterized by four different malignant cellular types. Multinucleated cells with distinct nucleoli as well as large vacuolated cells with hyperchromatic, eccentric nuclei showed the same cellular morphology seen in the corresponding histologic pictures. Granular eosinophilic cells, with pyknotic nuclei and distinct and/or ill-defined cytoplasmic borders, are believed to be the result of degenerative changes caused by the urinary environment. The multinucleated cell type was almost benign in appearance and could be confused with benign urothelial cells. The malignancy and the renal origin of such cells were confirmed by the observation of strikingly similar cells in the parent neoplasms.