A histopathologic study of urinary bladder tumors at tertiary care center in Mid-Western region of Nepal

Abstract

Background: Urinary bladder cancer is an important cause of morbidity and mortality due to urological conditions. It is tenth most common cancer overall in both sexes. It is seventh most common cancer overall and second most common cancer of genitourinary tract in males. Ninety five percent of bladder tumors are epithelial and the rest are mesenchymal, of which majority are primary urothelial tumors. Urothelial tumors are classified into infiltrating urothelial carcinoma with its variants and non-invasive urothelial neoplasias. Tumor stage is the strongest prognostic parameter.Aims and Objectives: The current study was designed with an aim to elucidate the histologic pattern of bladder tumors and observe whether any association between histologic grade and muscle invasion exists.Materials and Methods: This descriptive study was carried out on 84 cases of urinary bladder tumors received in Department of Pathology, College of Medical Sciences and Teaching Hospital during a time period of 5 years from January 2012 to December 2016.Results: The mean ± SD of age of presentation was 63±13 years with a male female ratio 3.2:1. Ninety-five percent cases were primary epithelial tumors and 93% cases were of urothelial origin. Low grade papillary urothelial carcinoma was the most common urothelial tumor (40.5%) followed by high grade papillary urothelial carcinoma (34.5%). Some rare types like primary adenocarcinoma and small cell carcinoma were also seen in this study (1.2% each). Muscle invasion was significantly higher in high grade (66%) as compared to low grade papillary urothelial carcinoma (3%). Muscle tissue was absent in 8 (9.5%) cases.Conclusion: There is relationship of histologic grade with aggressiveness of tumor. Most of the high grade tumors are muscle invasive at presentation. Submission of muscle tissue is important for optimal patient management.Asian Journal of Medical Sciences Vol.9(6) 2018 45-50

Incidence of various urothelial malignancy in patients undergoing transurethral resection of bladder tumour in tertiary care hospital

“…Majority of patients of urinary bladder tumor presents with the complaints of painless hematuria. In current study 88.75% patients presented with the complaints of hematuria which was closely correlated with studies conducted by Goyal B et al in which hematuria was seen in 91% of patients and 87% in study conducted by Tomescu et al 17,20 In present study 5% of the total patients presented with papilloma. Similar results were seen in study carried out by Goyal et al, in which 6% of the patients showed papilloma.…”

“…22 In a study carried by Sathya and Chhinnaswamy 38.6% of the patients showed low grade papillary carcinoma which was c. 23 In current study 88%of the low-grade papillary carcinoma was non-invasive, 12% of the low-grade carcinoma showed lamina invasion and no cases of muscle invasion was seen whereas in study conducted by Goyal et al, noninvasive papillary carcinoma was seen in 53 % of the patients, lamina propria invasion was seen in 35% of the patients and muscle invasion was seen in 3% of the patients closely related to this study. 20 In present study out of 80 patients 50 patients were diagnosed as case of high grade papillary urothelial carcinoma thus accounting to 62.5% of the total patients. In study conducted by Vaidya et al, out of 83 patients, 35 patients showed high grade transitional carcinoma.…”

“…In a study conducted by Laishram et al, 7.7% patients were diagnosed with papilloma. 20,21 Low grade papillary carcinoma forms an important group in classification of urothelial carcinoma. In present study 32% of the total patients showed low grade papillary carcinoma.…”

“…Same results were seen in study conducted by Goyal et al, in 66% patients muscle invasion was seen and in 17% patients lamina propria invasion was seen which accounts to 52.24 % of total patients taken. 20…”