Malignant cells in urine cytology that are arranged in papillary fragments with fibrovascular cores suggest upper tract origin (renal pelvis or ureter), as these structures are more characteristic of papillary tumors in the upper urinary tract. While papillary configurations can occur in bladder tumors, their presence in cytology, especially with well-formed papillae, should raise suspicion for upper tract involvement. Other features favoring upper tract include cylindrical casts of malignant cells (suggesting ureteral origin) and clinical presentation (unilateral hematuria, flank pain). Definitive localization requires imaging or ureteroscopy.

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Zambia

• ivwananji siwale – 29 pts

• Visual Pathway Lesions
• Positive and Negative Symptoms
• Hallucinations and Delusions
• Antipsychotic Medications
• Emergency: Environmental Emergencies