[A clinico-pathological study of primary carcinoma in situ of the upper urinary tract: urinary cytology and pathological study of cases reported in Japan, including our three cases, by mapping].

We herein report three cases of primary carcinoma in situ (CIS) of the upper urinary tract. The significance of urinary cytology and pathological study by means of mapping of isolated specimens was investigated in cases reported in Japan, including our cases. 1. The most common clinical symptom of CIS of the upper urinary tract was hematuria. Particularly, gross hematuria showed a high incidence. 2. In cases of CIS involving the ureter, hydronephrosis frequently resulted from ureteral stenosis and obstruction. 3. Urinary cytology was a useful diagnostic examination, in particular, the cytology of catheterized urine or washings increased the diagnostic accuracy. It appeared that for definite diagnosis, positive urinary cytology should be obtained repeatedly. 4. The mapping analysis of isolated specimens revealed that it was characterized that CIS was multiple and coexistent with dysplasia. 5. Total nephroureterectomy is the treatment of first choice. An investigation of the distribution of CIS and dysplasia by mapping and grading of CIS seemed to be useful for following up the postoperative course.