Histomorphological Study of Urinary Bladder Biopsies- A Retrospective Study in a Tertiary Care Centre, Kerala, India

Abstract

Introduction: Urinary bladder diseases are quite frequent in clinical practices. Both non neoplastic and neoplastic lesions are quite common. Bladder malignancies are on an increasing incidence and are considered as an important cause of cancer related morbidity and mortality. To provide accurate diagnosis and treatment histopathology remains as the gold standard investigation. Aim: To study the histomorphology of lesions of bladder obtained through Trans Urethral Resection of Bladder Tumour (TURBT) and cystoscopic biopsies. Materials and Methods: The present study was a five years descriptive retrospective study conducted over a period of six months starting from July 2020 to December 2020 and data were collected from records for the period of January 2015 to December 2019 carried out in the Department of Pathology, Government Medical College, Trivandrum, Kerala, India. Record of all patients who visited to Urology Outpatient Department (OPD) with lower urinary tract symptoms and obstructive bladder symptoms and subjected to cystoscopy were included in study. The detailed clinico-histomorphological features of all biopsies were studied using World Health Organization (WHO)/ International Society of Urologic Pathologists (ISUP) 2016 histological grading and Tumour (T), Nodes (N), and Metastasis (M) (TNM) staging were used in classifying the bladder tumours. Results: The data for the present study was collected over a period of five years; during which a total of 742 lesions were histopathologically evaluated. A total of 688 cases (92.72%) were neoplastic, 46 cases (6.19%) were diagnosed as non neoplastic and 8 cases were (1.07%) were metastatic malignancy. A total of 646 cases (87.06%) were males. Most common affected age group was 61-80 years. Haematuria was the most common clinical presentation. A 332 cases (48.25%) were of non invasive papillary urothelial neoplasm low grade. Conclusion: Lesions of urinary bladder are heterogenous in nature. Detailed awareness regarding the various histological features of these lesions, their neoplastic potential, risk of recurrence and possible pitfalls can help pathologists for accurate diagnosis. The study also emphasised on inclusion of smooth muscle in the biopsy for accurate grading and staging in bladder tumours.