Abstract
The mucosal lesions in the lower urinary tract were examined in 86 cystectomy specimens of bilharzial bladder cancer. Squamous cell carcinoma occurred in 66 cases, transitional cell carcinoma in 18 cases, and adenocarcinoma in two cases. Multiple infiltrative carcinomas were found in 19 cases (22.1%), and these were commonly of the transitional cell type (63.9%). Squamous metaplasia was found in 65.1%, columnar metaplasia in 52.3%, and carcinoma in situ in 40.7%. The ureters, trigone, and urethra were rarely affected by these lesions. Carcinoma in situ was more commonly associated with multiple carcinomas (68.4%) than with single tumors (32.8%). Squamous metaplasia was found in 81.8% of squamous cell carcinomas and in 16.7% of transitional cell carcinomas. The two cases of adenocarcinoma were associated with columnar metaplasia in the adjacent mucosa. Squamous cell carcinoma and adenocarcinoma probably arise from metaplastic epithelium. Total or subtotal cystectomy is recommended because of the high incidence of carcinoma in situ (40.7%) and multiple carcinomas (22.1%).
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