Abstract
Introduction: Urinary bladder is a site of various non-neoplastic and neoplastic lesions, both of which can present with hematuria. Cystoscopy allows for direct visualization of the bladder mucosa and also obtaining tissue for histopathologic evaluation. The most common non-neoplastic and neoplastic lesion of the urinary bladder is non-specific cystitis and urothelial carcinoma respectively. Materials and methods: This study is a 4-year retrospective study conducted in the Department of Pathology at Patan Hospital, Nepal. All cases from the urinary bladder i.e., both cystoscopic and cystectomy samples were included in the study. Hematoxylin and eosin-stained slides were re-evaluated whenever required. Results: A total of 145 cases were included which consisted of 17 cystectomy specimens and 128 cystoscopic biopsies. There was a male predominance. The non-neoplastic and neoplastic cases consisted of 32% and 68% respectively. Chronic non-specific cystitis and high-grade infiltrating urothelial carcinoma were the most common non-neoplastic and neoplastic lesions respectively. 56.1% of cystoscopic biopsies had the presence of detrusor muscle with 21.7% showing its invasion. Conclusions: Urinary bladder lesions have a wide spectrum ranging from non-neoplastic to neoplastic conditions. The presence of detrusor muscle in a cystoscopic biopsy, and its evaluation for invasion helps in diagnosis and further planning of patient management.
Highlights
Urinary bladder is a site of various non-neoplastic and neoplastic lesions, both of which can present with hematuria
Chronic non-specific cystitis and high-grade infiltrating urothelial carcinoma were the most common non-neoplastic and neoplastic lesions respectively. 56.1% of cystoscopic biopsies had the presence of detrusor muscle with 21.7% showing its invasion
The WHO/ ISUP classification of urinary bladder tumor, 2016 has laid down the classification of invasive and non-invasive bladder tumors.4At least 75 – 80 % of newly diagnosed bladder tumors are superficial, non-invasive papillary urothelial carcinoma, and at least 50 – 75% of these tumors recur over time.[5]
Summary
Urinary bladder is a site of various non-neoplastic and neoplastic lesions, both of which can present with hematuria. Cystoscopy allows for direct visualization of the bladder mucosa and obtaining tissue for histopathologic evaluation. The most common non-neoplastic and neoplastic lesion of the urinary bladder is non-specific cystitis and urothelial carcinoma respectively. Cystoscopy is the principal diagnostic tool in investigating bladder lesions. It provides direct visualization of the bladder mucosa and allows for the collection of biopsy for histopathologic evaluation.[1] Cystitis is a common non-neoplastic lesion and urothelial carcinoma is the most common malignancy in the bladder.[2,3] The incidence of bladder tumors is higher in males than females and more common in urban areas than in rural locations. The WHO/ ISUP classification of urinary bladder tumor, 2016 has laid down the classification of invasive and non-invasive bladder tumors.4At least 75 – 80 % of newly diagnosed bladder tumors are superficial, non-invasive papillary urothelial carcinoma, and at least 50 – 75% of these tumors recur over time.[5]
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