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The Paris System for Reporting Urinary Cytology: The Quest to Develop a Standardized Terminology

Barkan, Güliz A. MD, FIAC; Wojcik, Eva M. MD, MIAC; Nayar, Ritu MD, MIAC; Savic-Prince, Spasenija MD; Quek, Marcus L. MD, FACS; Kurtycz, Daniel F.I. MD; Rosenthal, Dorothy L. MD, FIAC

Advances In Anatomic Pathology: July 2016 - Volume 23 - Issue 4 - p 193–201
doi: 10.1097/PAP.0000000000000118
Review Articles

The main purpose of urine cytology is to detect high-grade urothelial carcinoma. With this principle in mind, The Paris System (TPS) Working Group, composed of cytopathologists, surgical pathologists, and urologists, has proposed and published a standardized reporting system that includes specific diagnostic categories and cytomorphologic criteria for the reliable diagnosis of high-grade urothelial carcinoma. This paper outlines the essential elements of TPS and the process that led to the formation and rationale of the reporting system. TPS Working Group, organized at the 2013 International Congress of Cytology, conceived a standardized platform on which to base cytologic interpretation of urine samples. The widespread dissemination of this approach to cytologic examination and reporting of urologic samples and the scheme’s universal acceptance by pathologists and urologists is critical for its success. For urologists, understanding the diagnostic criteria, their clinical implications, and limitations of TPS is essential if they are to utilize urine cytology and noninvasive ancillary tests in a thoughtful and practical manner. This is the first international/inclusive attempt at standardizing urinary cytology. The success of TPS will depend on the pathology and urology communities working collectively to improve this seminal paradigm shift, and optimize the impact on patient care.

Departments of *Pathology

§Urology, Loyola University Healthcare Systems, Maywood

Department of Pathology, Northwestern Memorial Hospital, Chicago, IL

Institute of Pathology, University Hospital Basel, Basel, Switzerland

Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Wisconsin State Laboratory of Hygiene, Madison, WI

Department of Pathology, The Johns Hopkins University, Baltimore, MD

Because of the nature of this paper an IRB approval is waived.

The Paris System for reporting urinary cytology was presented for the first time at the Annual USCAP meeting in San Diego in March 2014.

The authors have no funding or conflicts of interest to disclose.

The Paris System for Reporting Urinary Cytology: The Quest to Develop a Standardized Terminology” is jointly published by Advances in Anatomic Pathology, Acta Cytologica, and The Journal of the American Society of Cytopathology on behalf of Güliz A. Barkan, Eva M. Wojcik, Ritu Nayar, Spasenija Savic-Prince, Marcus L. Quek, Daniel F.I. Kurtycz, and Dorothy L. Rosenthal.

Reprints: Güliz A. Barkan, MD, FIAC, Department of Pathology, Loyola University Healthcare System, 2160 S. First Ave., Building 110, Room 2238, Maywood, IL 60153 (e-mail:

All figures can be viewed online in color at

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