Importance of identification of prostatic adenocarcinoma in urine cytology

Xiaoqi Lin*, Brian J. Jordan, Yaxia Zhang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Prostate carcinoma (PCa) occasionally involves the urethra and/or bladder. In these cases, PCa cells may be detected in urine. The purpose of this study was to describe the salient cytomorphologic, immunocytochemical, and epidemiologic features of PCa cells detected in urine cytology slides via a retrospective case series review. Materials and Methods: We retrospectively identified 28 cases with urine cytology either suspicious or positive for PCa. Clinical and histopathologic data were reviewed. Results: We identified 23 prostatic acinar adenocarcinomas (PAAs) and 5 prostatic adenocarcinomas with ductal features (PDAs). Urine cytology was the first evidence of disease in 6 (26%) patients with PAA and in 4 (80%) of the patients with PDA. In patients with PAA, 17 had a previous history of PAA, with positive urine cytology in the setting of disease recurrence or persistence within the bladder or urethra. The PAA in urine presented as single or small clusters of atypical cuboidal glandular cells with large, eccentric, round, or oval uniform nuclei containing conspicuous nucleoli, and scant to moderate delicate or granular cytoplasm, whereas the PDA presented as atypical columnar glandular cells in flat nests or 3-dimensional clusters, and with prominent nucleoli. Conclusions: Using standard urine cytology, we were able to detect PCa cells in the urine. Although rare, PCa was first diagnosed by urine cytology in select cases, with a higher frequency in patients with PDA. Clinicians should be aware that PCa cells can be identified by urine cytology as this can lead to an earlier diagnosis and treatment.

Original languageEnglish (US)
Pages (from-to)268-273
Number of pages6
JournalJournal of the American Society of Cytopathology
Issue number5
StatePublished - Sep 1 2018


  • Clinical correlation
  • Clinical importance
  • Prostatic acinar adenocarcinoma
  • Prostatic ductal adenocarcinoma
  • Urine cytology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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