Risk of Malignancy in Atypical and Suspicious Categories of The Paris System: A Cyto-histopathological Correlation Study

Background The Paris System for Reporting Urinary Cytology (TPS) was introduced to improve standardization and diagnostic accuracy in urinary cytology, particularly for detection of high-grade urothelial carcinoma (HGUC). However, the indeterminate categories, namely Atypical Urothelial Cells (AUC) and Suspicious for High-Grade Urothelial Carcinoma (SHGUC), continue to represent significant diagnostic challenges due to variable risk of malignancy (ROM). Aim To evaluate the cyto-histopathological