Cytologic Features of Prostatic Adenocarcinoma in Urine: Comparison with Urothelial Carcinoma

Carcinoma cells of a prostate origin are rarely detected in urine cytology specimens. Although urine cytology is routinely performed in patients with urologic complaints, the clinical value is limited for making the diagnosis of prostate adenocarcinoma (PACa), and pathologists may not be familiar with the cytomorphology of these cells. However, it is important that cancer cells are recognized to be of a prostate origin and they should be distinguished from urothelial neoplasm because of the therapeutic implications. PACa cells have been frequently overlooked or misdiagnosed as urothelial malignancies in cases that have a lack of clinical information. Even though PACa may be clinically suspected, the cancer cells in urine specimens may reflect a synchronous carcinoma of the bladder. The cytologic features of PACa cells on urine cytology have been described; however, the clinical application of these cytologic features is challenging. The purpose of this study was to evaluate the cytologic findings of PACa in urine specimens, to determine the characteristic features favoring a prostate origin of cancer cells and to discriminate PACa from high-grade urothelial carcinoma (HGUCa) and urothelial carcinoma in situ (UCis). MATERIALS AND METHODS