A histological and cytopathological study of 54 patients with transitional carcinoma of the upper urinary tract was undertaken. There were 17 patients with grade 1 tumours, 35 with grades 2 or 3, and two with carcinoma in situ. Only 16 had non-invasive tumours. A preoperative cytological diagnosis of tumour was made in 67% of the group as a whole and in 75% of patients with grade 2 or 3 tumours. Seventy per cent of voided urines and 80% of ileal conduit urines were positive for tumour. Cytological grading correlated with histology in 12 of 14 grade 1 tumours and 26 of 35 grade 2 or 3 tumours, with seven assigned grade 1. Two cases of pelvicalycine carcinoma in situ were graded 3 by cytology. Cytological investigation by those experienced in urinary cytology has an important diagnostic contribution to make in transitional carcinoma of the upper urinary tract.
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