Pap stain, high power
Markedly atypical keratinized cells with background normal squamous cell for comparison. These cells are diagnostic of squamous cell carcinoma
Medium power: Pap stain
Rarely clusters with acellular keratin surrounded by atypical keratinized cells can be seen
Pap stain, high power
Tadpole like markedly atypical keratinized cell with irregular nuclear membranes and ink blot nucleus. High N:C ratio is virtually diagnostic of the carcinoma in this setting
Pap stain, high power
Three singly dispersed dyskeratotic cells with nuclear hyperchromasia and irregularity. Note the background does not show cells of high grade urothelial carcinoma
Pap stain, high power
Dysplastic, keratinized squamous cell with nuclear irregularity and high N:C ratio
Features
• Schistosomal infection
• Stones
• Cyclophosphamide
• Dysplastic squamous cells
• Dense cytoplasm
• Keratinization (orangeophilia)
• High nucleus to cytoplasmic ratio is essential
• Irregular nuclear contours
• Hyperchromasia (ink-blot nuclei)
• Squamous differentiation may be seen in high grade urothelial carcinoma and if features are focal, diagnosis of keratinizing squamous cell carcinoma should not be made.