A Decade-Review of the Paris System Lands Right as Urologic Surgical Pathology Rewrites Its Urine Cytology Chapter
In December 2025, Histopathology published Eva M. Wojcik's review, "The Paris System for Reporting Urinary Cytology: What Worked and What Still Needs to Be Improved," marking roughly a decade since The Paris System (TPS) was introduced to standardize bladder cancer cytology reporting. The review credits TPS's nuclear-to-cytoplasmic ratio threshold with reducing atypia rates and improving reproducibility across labs, while flagging degenerated-cell interpretation, molecular test integration, and early-stage AI-assisted screening as the areas genitourinary pathology services are now being pushed to modernize.
The fifth edition of Urologic Surgical Pathology (Elsevier, September 2026) arrives with exactly that update built in: a fully rewritten urine cytology chapter aligned to TPS 2.0, updated WHO classification and TNM staging covering molecularly defined genitourinary tumors, and — closing a long-documented gap in the genitourinary literature — a new dedicated chapter on the urachus.
In practice, that means: a surgical pathology service standardizing its own urine cytology reporting against TPS 2.0 gets the visual N/C-ratio aids and revised atypia categories the recent literature has been calling for. A genitourinary oncology tumor board reviewing a bladder or renal mass can connect the updated WHO/TNM chapters directly to molecular subtyping, staging, and grading. And pathology residents and fellows training on genitourinary specimens get an atlas of roughly 2,600 full-color gross, histologic, cytologic, and special-stain images to work from at the bench.
For a hospital or academic pathology library, this fifth edition replaces an aging genitourinary pathology text with one already aligned to the classification and reporting standards the department is being asked to use this year. See the full Medicine collection at CLNZ Books for related titles.
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Q&A
What did the 2025/2026 Histopathology review say about the Paris System?
It found TPS improved standardization and reproducibility in urine cytology since 2016, while flagging degenerated-cell interpretation, molecular test integration, and AI-assisted screening as unfinished work — the areas TPS 2.0 addresses.
How does Urologic Surgical Pathology, 5th Edition respond?
It includes a fully rewritten urine cytology chapter aligned to TPS 2.0, updated WHO classification and TNM staging for molecularly defined genitourinary tumors, and a new chapter on the urachus.
Who should read this edition?
Surgical pathologists, genitourinary pathology fellows, pathology residents, and urologists who work closely with pathology colleagues on diagnosis and staging.
Does it include updated cancer staging criteria?
Yes — it reflects the latest TNM staging and WHO classification, including molecularly defined genitourinary tumor types.
Where can I buy Urologic Surgical Pathology, 5th Edition?
It is available now at CLNZ Books, Bookseller for Professionals Worldwide.