49 year old male. I never smoked. do not work with chemicals. on routine physical microscopic hematuria was found +1 level. tested again 2 wks same +1. my primary ordered a voided cytology. came back dx " rare urothelial cells noted in a backround of acute inflammation". saw urologist. he did a cystoscopy. the only thing he saw was a small red spot. did a bladder wash cytology. came back
dx " numerous papillary fragments of uroepithelial epithelium. these findings can be seen with instrumentation or a low grade lesion cant be ruled out". my obvious concern is CIS. my uro said that the lesion was not velvety in appearance and did not look like cis, but he said 20% of the time they don't appear classic. the cytologist suggested a low grade lesion. Q!-if this were cis wouldn't that have showed up on the cytology as a high grade lesion. Q2-are papillary fragments a part of cis. uro was positive he saw nothing else. he told me cis can be low grade? Q3- primary cis is very rare from what I understand. I need your honest opinion as to the odds I have cis or a low grade pappilary lesion. don't pull any punches. thank you, patrick