The urothelial lining is considerably thickened consisting of 12 to 15 layers of cells. There is some loss of polarity with minimal nuclear pleomorphism, nuclear enlargement and hyperchromasia. Mitotic activity is not increased. There is no inflammation to account for these cytologic changes. The degree of atypia is not severe enough to justify the diagnosis of CIS and such lesions are best classified as dysplastic.
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