Spectrum of Lesions in Urinary Bladder- A Histopathological Study

Abstract

Introduction: The lesions of urinary bladder both non-neoplastic and neoplastic pose a common source of both morbidity and mortality. An accurate diagnosis of these lesions requires cystoscopy which allows a direct visualization of the bladder mucosa and biopsies of suspected lesions. Urinary bladder cancer is sixth most common cancer worldwide and represents a heterogeneous group of neoplasms. The current study aimed to study the different bladder lesions and its clinical features to detect it in early stage and as a mainstay option in the diagnosis and follow up.
 Materials and methods: This was a retrospective analysis of biopsies of urinary bladder submitted to the department of pathology over a period of 12 months. The study was approved by the institutional review board of the Universal College of Medical Sciences (UCMS-TH). All the urinary bladder biopsies received in the department were included in the study whereas autolysis of specimen and inadequate biopsies were excluded.
 Results: Among the 36 cases of urinary bladder lesions, the majority (35.36%) were in age group 61-70 years (22.33%). The patients had combination of lower urinary tract symptoms, the commonest being hematuria. 30.55% had non-neoplastic lesions and 69.55% had neoplastic lesion. Among non- neoplastic cases, 5.55% had chronic granulomatous inflammation. Most common neoplastic lesions was infiltrating urothelial carcinoma (n=6) followed by non- invasive urothelial neoplasia (n=5).
 Conclusion: A variety of lesions occur in urinary bladder and is commonly encountered by pathologist. Hematuria was commonest symptom and the clinicians investigated these patients further, which led to discovery of the urothelial tumors. Identification of these patients has an important impact on prognosis as well as on therapeutic approach.

Histomorphological spectrum of urothelial tumors according to WHO/ISUP consensus classification (2016): Tertiary care center study

“…In non-invasive papillary urothelial neoplasia, predominant type was PUCLG (55.33%) followed by PUCHG (14%), papillomas (13%) and PUNLMP (3.34%). This was in concordance with studies performed by Laishram RS et al [22] who showed maximum number of PUCLG (53.9%) followed by PUCHG (37.6%), papillomas (7.7%) and PUNLMP (3.9%) and Thapa et al [17] who observed high prevalence of PUCLG (50%) followed by PUCHG (30.36%), PUNLMP (10.71%) and papilloma (9%).Our study was also in concordance with Shah P et al [23] who observed maximum no. of non-invasive PUCLG (47.36%) in prevalence of PUCLG (50%) followed by PUCHG (30.36%), PUNLMP (10.71%) and papilloma (9%).Our study was also in concordance with Shah P et.…”

Histopathological Spectrum of Urothelial Lesions: An Observational Study

“…The male to female ratio from various studies highlight the association between bladder neoplasms and increased m a l e s u s c e p t i b i l i t y. P re s e n t s t u dy a l s o h a d m a l e preponderance with M: F ratio of 4:1. However, the range of this ratio is very wide as observed in various studies ranging from least being observed is 2.29:1 in study by Shah PY et al [16] to highest observed ratio of 5.25:1 in study by Srikoustubah [17] et al Smoking had a predominant role in development of bladder cancer in males along with other factors such as occupational carcinogens like aniline dyes (particularly benzidine and β-naphthylamine), auramines, phenacetin and cyclophosphamide. Schistosoma haematobium is also thought to be pathogenetically related to urothelial (and squamous cell) carcinoma of bladder Incidence among females could be explained by use of smokeless tobacco in the forms like gutkha, paan, khaini, tobacco or surti.…”

Spectrum of lesions in urinary bladder biopsies: A histopathological study

“…Urinary bladder lesions are responsible for significant morbidity and mortality [1] . urothelial carcinoma is the 6 th most common cancer worldwide [2] . Cystoscopy is the primary investigation to diagnose bladder lesion and rule out bladder cancers in suspected cases.…”

“…histopathological examination of bladder biopsies not only gives the diagnosis but also provides information to the Urologist to plan treatment. Diagnosis and monitoring of bladder lesions are made by combining cystoscopic and histopathological findings [2,3] . 147 bladder biopsies were analyzed in the present study.…”

“…Non neoplastic lesions are more disabling than lethal [1] . Urinary bladder cancer is the sixth most common cancer worldwide and the second most common malignancy of the genitourinary tract after prostate cancer [2] . Among bladder tumors, urothelial carcinoma is the commonest accounting for 90% of all the primary tumors of the bladder.…”