Pumping法による膀胱腫瘍の細胞診および腫瘍細胞染色体の検索

Abstract

Cytodiagnosis has been accepted as one of the diagncstic measures of bladder tumor for many years. Its clinical value, however, has not been so highly esteemed in urology as compared with other fields, probably because of easy endoscopy and transurethral biopsy, and obscure criteria of malignancy in transitional cells. Cytological examination is valuable and even necessary for screening of industrial bladder cancers, early diagnosis, follow-up after treatment, diagnosis of carcinoma in situ or cases in which cystoscopy is contraindicated. Cytological examinations were performed as follows. After catheterization with Nelaton's catheter, pumping irrigation was done. Irrigated solution was then spun, and the sediment was smeared, dried, and stained by May-Giemsa's method. Several cases were demonstrated. Case No.1: Six weeks prior to the first cystoscopic diagnosis, cytological examination was already positive. Case No.2: This was a follow-up case after TUR for bladder tumor. Cytological examination became positive but it was impossible to establish diagnosis by cystoscopy only. Biopsy revealed carcinoma in situ and infiltrating cancer. Case No.3: Cystoscopically the findings were those of cystitis, but cytological examination revealed neoplasm of high malignancy. Chromosome analysis of the exfoliated tumor cells obtained by pumping method was performed in a few cases. If chromosome study could be routinely made associated with cytological examination, malignancy of the tumor would be more clearly decided and provide with a helpful information as to treatment and prognosis. Then, the value of cytodiagnosis would be increased.