Urothelial Carcinoma-In-Situ : Clinging Type

Given its discohesive nature, urothelial CIS readily sheds neoplastic cells in urine. In a small biopsy harboring CIS, the surface urothelium is sometimes completely denuded, leaving behind a single layer of cells or only rare cells that meet the diagnostic criteria of malignancy. The term "denuding cystitis" has been sometimes applied in such cases. In biopsies with complete denudation of overlying urothelium, one should be careful before labeling them benign. Obtaining multiple levels in such cases is helpful in visualizing the rare neoplastic cells. Urine cytology often tends to be positive for malignant cells in such cases.