Urothelial Neoplasms of Urinary Bladder - A Clinicopathological Correlative Study

Abstract

BACKGROUND Transitional cell carcinoma also known as urothelial carcinoma accounts for more than 90 % of all primary tumours of urinary bladder. It is the 4 th most common cancer in men and 8 th most common cancer in women in the western world. Nearly 80 % of patients initially present with bladder tumours confined to mucosa or submucosa. Not grading but detection of infiltration is of much value when dealing with invasive urothelial malignancy. When it invades muscle, it dictates more aggressive treatment. This study was undertaken to correlate the clinical, radiological, and pathological findings in the grading and staging of carcinoma bladder. METHODS This prospective study was conducted in the Department of Pathology for a period of two years. 55 patients with clinical features suggestive of carcinoma bladder were included in the study. Radiological and cystoscopic findings were combined to obtain a clinical staging. Materials included were H&E stained sections of biopsies, TURBT and Cystectomy. Special stains were done in indicated cases. Grading was done using WHO / ISUP grading system and staging using AJCC / UICC staging system. RESULTS 55 cases were studied. Most common age group was 60 - 69 years (40 %) with male preponderance (94.5 %). 100 % of patients presented with haematuria. Cystoscopically most common appearance was fronds (69.1 %) involving right lateral wall (40 %). Of the clinically invasive cases 29 (52.7 %), 19 (65.50 %) were pathologically invasive, 3 (10.3 %) were pathologically noninvasive, 7 (24.10) were insufficient for opinion. Of the clinically noninvasive cases (26), 5 (19.20 %) were pathologically invasive 13 (50 %) were noninvasive and rest were insufficient for opinion. CONCLUSIONS Bladder carcinomas are more common in elderly males. All patients presented with haematuria. Most common site of involvement was lateral walls. Clinicopathological correlation was more in highly advanced cases. KEYWORDS Urothelial Carcinoma, Grading, Staging