A Clinicopathologic Study of Urinary Bladder Lesions Amongst North Indian Population: An Experience From a Tertiary Care Centre

TL;DR

This study examines bladder lesions in a North Indian population, finding that high-grade infiltrating urothelial carcinoma is the most common type.

Contribution

The study provides clinicopathologic insights into bladder lesions specific to the North Indian population.

Findings

Infiltrating urothelial carcinoma high grade was the most common bladder lesion.

Muscle invasion was more common with higher-grade lesions.

Urine cytology and immunohistochemistry are valuable for diagnosis and tumor typing.

Abstract

Background: Urinary bladder cancer (UBC) is amongst the most common urological malignancies.

Aim: To study different types of urinary bladder lesions in the north Indian population and to correlate various clinical and pathological findings.

Materials and methods: The present prospective study was conducted on 100 cases undergoing transurethral resection of bladder tumor (TURBT) and/or radical cystectomy over a period of 2.5 years followed by histopathological examination. Liquid-based cytology for malignant cells in urine was also performed. Immunohistochemistry was employed for tumor typing wherever needed.

Results: A total of 100 cases were studied. Male to female ratio was 15.7:1 and most of the patients were in the sixth decade (40%). Painless hematuria was the commonest clinical presentation (60%) and smoking was the commonest risk factor (80%). The most common lesion was infiltrating urothelial carcinoma seen in 72 cases followed by papillary urothelial neoplasm of low malignant potential (PUNLMP) seen in eight cases. Grade and depth of invasion were assessed and correlated. Several variants of infiltrating urothelial carcinoma such as squamous differentiation, glandular differentiation, microcystic, clear cell, nested, and micropapillary were also identified. Clinical, cystoscopic and histopathological findings were correlated in all the cases.

Conclusion: Infiltrating urothelial carcinoma high grade was the most common bladder lesion identified and muscle invasion was more common with higher-grade lesions. A decade-younger age group was found to be more affected in the present series. Urine cytology for malignant cells is useful for early diagnosis of cancer. Immunohistochemistry is an important ancillary adjunct.

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