A 57 year old male had a routine urinalysis as part of his company's yearly required physical examination. His only complaints referable to the urinary tract are some mild dysuria and hesitancy, but he otherwise feels fine. The atypical urothelial cells suggest the possibility of a carcinoma. The presence of the RBC's is consistent with that. He should be referred to a urologist, who can do cystoscopy to look at the bladder urothelium, collect urine for cytology, and biopsy any suspicious areas.
Smokers have an increased risk for urothelial malignancies.
A history of exposure to beta-naphthylamine and analine dyes is also a risk.