Histopathological study of urinary bladder tumors in a tertiary care hospital

Introduction: Urinary bladder cancer ranks 9th in worldwide cancer incidence. It is the 7th most common malignancy in men and the 17th most common in women. (1) Urinary bladder carcinoma accounts for 5.6% of cancer in males and 1.8% of cancer in females in India. Aims and objectives: To study the histopathological pattern of urinary bladder tumors and to compare the histopathological spectrum of urinary bladder tumors in various age groups and genders at a tertiary care hospital in Kashmir valley (SKIMS). Materials and Methods: The study was conducted in the Department of Pathology at the Sher-i-Kashmir Institute of Medical sciences (SKIMS), Kashmir and included retrospective data analysis for 4 years and a prospective study over a period of 1 year. The specimens/biopsies for urinary bladder tumors received in the Department of Pathology were properly labeled, numbered and then subjected to gross and detailed histopathological examination. The specimens/ biopsies were fixed in 10% buffered formalin. Biopsies were measured. The specimens (partial cystectomy/ cystectomy) were measured and a detailed gross examination was carried out. Gross photographs of the specimens were taken. The tissue was processed as per standard procedure 4-5 micron sections were cut on microtome and stained by haematoxylin and eosin stain and special stains like PAS was done when required. The findings were then analyzed. Microphotographs of tumors were to represent various histological types. Results: A total of 433 cases were received. Out of those 413 cases (95.7%) were TUR biopsies followed by cystectomy specimens i.e. 13 cases (3%). Cases received for review were 4 (0.9%). Partial cystectomy specimens were least common specimens received i.e. 3 cases (0.7%). Of the total of 433 urinary bladder specimens/ biopsies studied, 411 (94.92%) were found to be neoplastic and 22 (5.08%) were non -neoplastic. Thus majority of urinary bladder lesions comprised of neoplastic lesions. Out of 379 cases of TCC, 315 cases (83.11%) were primary and 64 cases (16.89%) were recurrent. Of the 353 urinary bladder lesions in males, non- neoplastic lesions seen were 18, benign were 16 and 319 were found to be malignant, including 310 TCC cases. Conclusion: Higher number of Bladder tumors are found in males as compared to females. The most common clinical presentation was hematuria followed by lower urinary tract symptoms, pain abdomen and retention of urine. Right posterolateral wall was the most common site of tumor in Radical cystectomy specimen. Transitional cell carcinoma was the most common tumor type. Muscle invasion was seen in 22.89% of malignant cases and there was increasing trend of cases annually.