Urinary Bladder Lesions Research Articles

SPECTRUM OF HISTOMORPHOLOGICAL LESIONS IN CYSTOSCOPIC URINARY BLADDER BIOPSIES

Urinary bladder tumors were one of the most common entities of urological pathology. Neoplastic & nonneoplastic lesions of urinary bladder were the common reasons for morbidity and mortality throughout world. Among neoplastic lesions, urothelial carcinoma is a common primary tumor of urinary bladder. The aim of this retrospective study was to determine the spectrum of various urothelial lesions from cystoscopic bladder biopsies received over a period of 3 years. All the urinary bladder biopsies received with two inadequate biopsies were included in this study. Out of 54 biopsies received, 12 were non neoplastic & 40 were neoplastic cases and two were inadequate biopsies. Majority of the cases were in 60-79 years age group. Males were affected more than females ( 2.85:1 ratio). Majority of the neoplastic lesions were urothelial carcinomas. Conclusion : Among the bladder tumors ,urothelial carcinoma was the most common type, among these, high grade urothelial carcinoma was common in our study. Non invasive were more common than invasive carcinoma.Identification of grade &invasion into muscle layer has an impact on prognosis as well as on therapeutic approach.

Villous Morphology in Urinary Bladder Biopsy: An Approach to Diagnosis.

Villous morphology in urinary bladder biopsy is a relatively uncommon finding. Villi are slender, finger-like structures that are commonly seen in the small intestine or in neoplastic lesions of gastrointestinal lineage/differentiation. Importantly, placenta also exhibits villi that are morphologically and functionally different from the intestinal one. Majority of the neoplastic lesions of urinary bladder are urothelial in origin with a minor subset showing glandular differentiation. While the presence of benign villi in urinary bladder biopsy necessitates a search for an occult perforation, provided a sample mismatch is ruled out, cytoarchitecturally abnormal/dysplastic villi indicate a neoplastic lesion of the urinary bladder encompassing villous adenoma and adenocarcinoma and urothelial carcinoma with villoglandular differentiation. The dysplastic villi in urinary bladder also imply a lower gastrointestinal endoscopy to rule out a colorectal primary. The development of the villous lesions in the urinary bladder and the colorectum are embryologically related and pose a major diagnostic challenge to the clinicians and surgical pathologists due to identical histomorphology and immunohistochemistry. We tend to discuss the morphological differentials and diagnostic approach to the villous lesions in the urinary bladder biopsy.

Histomorphologic study of cystoscopic urinary bladder biopsies: A gold standard

Histomorphologic study of cystoscopic urinary bladder biopsies: A gold standard - IJPO- Print ISSN No: - 2394-6784 Online ISSN No:- 2394-6792 Article DOI No:- 10.18231/j.ijpo.2019.034, Indian Journal of Pathology and Oncology-Indian J Pathol Oncol

Allyl-isothiocyanate ameliorates the pre-neoplastic changes induced by the fern Dryopteris nigropalaceae on experimental feeding in Guinea pigs

Enzootic bovine haematuria, caused by long-term ingestion of ferns, is a chronic disease of hill cattle characterized by neoplastic lesions in the urinary bladder. Objectives of this study were to investigate the toxicity potential of long-term feeding of the fern Dryopteris nigropalaceae and effect of allyl isothiocyanate (AITC) to ameliorate fern toxicity and the associated pathological changes. The LC-MS analysis of the fern showed presence of ptaquiloside (4.5 ± 1.0 μg/g) and pterosin B (39 ± 9.1 μg/g). Groups of animals were fed dried fern powder at the dose of 20% w/w in normal feed and treated with and without AITC at graded doses. Long term feeding of fern induced inflammatory and pre-neoplastic lesions in urinary bladder. The important lesions included cystitis, squamous metaplasia and high-grade dysplasia. Urothelium showed positive immunoreactions for nuclear expression of H-ras and p53. However, no mutation suggestive of neoplastic change was observed on partial mRNA sequences analyses of exon 2 of H-ras and 5 or 7&8 of p53 genes. Strikingly, AITC showed dose-dependent amelioration of pre-neoplastic changes in fern-fed animals. In conclusion, AITC is shown to limit pre-neoplastic changes caused by D. nigropalaceae feeding in guinea pigs.

Benign Glandular Lesions of Urinary Bladder: Diagnostic Dilemma and Clinical Significance

Benign Glandular Lesions of Urinary Bladder: Diagnostic Dilemma and Clinical Significance

Clinicopathological study of non-neoplastic urinary bladder lesions

Clinicopathological study of non-neoplastic urinary bladder lesions

A clinicopathological study of neoplastic urinary bladder lesions with special emphasis on the role of urine sediment cytology in their diagnoses

Introduction: Neoplastic lesions of the urinary bladder constitute a diverse group of lesions. Bladder cancer is the 7th most common cancer worldwide. The present study is undertaken to study the spectrum of neoplastic bladder lesions and analyze their patterns with clinical features and urine sediment cytology. Materials and Methods: 82 cases of neoplastic bladder lesions were categorized according to WHO classification (2016) and were correlated with demographic variables and clinical variables. In prospective cases urine sediment was analyzed and was correlated with histopathology. Results: Out of 82 cases, majority of cases were infiltrating urothelial carcinoma. Analysis of urine cytology revealed a sensitivity of 86.67%, specificity of 83.3%, positive predictive of 92.86% and negative predictive value of 71.43%. Conclusion: Neoplasms of urinary bladder are diverse in their presentation with urine sediment cytology proving to be a valuable adjunct in early diagnosis and treatment.

Histomorphological spectrum of urothelial tumors according to WHO/ISUP consensus classification (2016): Tertiary care center study

Background: Neoplastic urinary bladder lesions are responsible for significant morbidity and mortality throughout the world. The WHO/ISUP consensus classification (2016) for Urothelial tumors reflects an improved understanding and knowledge of the morphological types. The new diagnostic categories will increase the diagnostic reproducibility, clinicopathological correlation and prognostication. The most important criterion for optimal cancer treatment is a correct classification of the tumor. Aim & Objectives: The aim is to study Histomorphological spectrum of urothelial tumors according to World Health Organization / International Society of Urological Pathology consensus classification (2016) and to determine age and sex distribution of urothelial tumors. Material & Method: Study included 300 urothelial tumor specimens, conducted over a period 15 months, extending from March 2016 to May 2017. H & E stained sections were examined for morphologic diagnosis of urothelial neoplasm. An attempt was made to classify urothelial neoplasm according to WHO/ISUP consensus classification (2016) by two senior consultants of the department. Results: Among 300 cases, 14.33% cases were diagnosed as Infiltrating urothelial carcinoma, 85.66% cases were of Non-invasive urothelial neoplasia. Amongst which Non-invasive papillary urothelial carcinoma, low grade were most common that is 55.33% cases. Maximum no. of cases was diagnosed (33%) in 61-70 years of age group and male Female ratio being 3:1.Conclusion: This study documents a high frequency of non-invasive than infiltrating type of urothelial neoplasm. Non-invasive papillary urothelial carcinoma, low grade constitutes the commonest of urothelial tumors. Urothelial tumors are seen commonly in seventh decade with overall a male predominance.

Pathomorphologic Characteristics of Non-Neoplastic Lesions in Bovine Urinary Bladders

Non-neoplastic epithelial and
 stromal changes might be prognostic in early phase of premalignant neoplastic
 developments of urinary bladder. In this regard, diagnosis and histological classification
 of these lesions give valuable knowledge for prevention and treatment in both
 human and veterinary medicine. In Turkey, bovine urinary bladder lesions have
 been encountered in great ratio even though the small numbers of cases have been
 observed in other animals. According to our great experiences and field-studies
 for years concentrating on the topic, inflammatory and neoplastic of
 pathologies in urinary bladders might be easily developed after long term Bracken
 fern-consuming cattle. In current study, non-neoplastic cases including mainly
 epithelial, stromal, vascular, and inflammatory characteristic lesions were
 identified and described separately. Degenerative, desquamative, cystic,
 hyperplastic, and metaplastic lesions were found prominently in urinary bladder
 epithelium. Consecutive lesions comprised stromal changes and vascular lesions
 characterized with circulatory problems. Accompanying those, remarkable mononuclear
 cell infiltrations were found in a lot of cases. In conclusion, such kind of non-neoplastic
 lesions at least should be considered as important as neoplastic lesions
 because the lesions can have a risk in course of premalignant neoplastic
 transformation.

Spectrum of Lesions in Urinary Bladder- A Histopathological Study

Introduction: The lesions of urinary bladder both non-neoplastic and neoplastic pose a common source of both morbidity and mortality. An accurate diagnosis of these lesions requires cystoscopy which allows a direct visualization of the bladder mucosa and biopsies of suspected lesions. Urinary bladder cancer is sixth most common cancer worldwide and represents a heterogeneous group of neoplasms. The current study aimed to study the different bladder lesions and its clinical features to detect it in early stage and as a mainstay option in the diagnosis and follow up.
 Materials and methods: This was a retrospective analysis of biopsies of urinary bladder submitted to the department of pathology over a period of 12 months. The study was approved by the institutional review board of the Universal College of Medical Sciences (UCMS-TH). All the urinary bladder biopsies received in the department were included in the study whereas autolysis of specimen and inadequate biopsies were excluded.
 Results: Among the 36 cases of urinary bladder lesions, the majority (35.36%) were in age group 61-70 years (22.33%). The patients had combination of lower urinary tract symptoms, the commonest being hematuria. 30.55% had non-neoplastic lesions and 69.55% had neoplastic lesion. Among non- neoplastic cases, 5.55% had chronic granulomatous inflammation. Most common neoplastic lesions was infiltrating urothelial carcinoma (n=6) followed by non- invasive urothelial neoplasia (n=5).
 Conclusion: A variety of lesions occur in urinary bladder and is commonly encountered by pathologist. Hematuria was commonest symptom and the clinicians investigated these patients further, which led to discovery of the urothelial tumors. Identification of these patients has an important impact on prognosis as well as on therapeutic approach.

Spectrum of Urothelial lesions in Cystoscopic biopsies: A Histopathological Perspective

Background: Urinary Bladder lesions are one of the most common presenting lesions in the Outpatient department. On the other hand neoplastic conditions of the urinary bladder are the major cause of morbidity and mortality. Bladder carcinoma is the 7th most common carcinoma worldwide and is the major cause of morbidity and mortality.Material & Methods: All the cystoscopic biopsy received in the Department of Pathology at Nobel medical college and teaching hospital from August 1st 2016 to July 31st 2017 was included in the study. Received cystoscopic biopsies were processed and classified as per 2004 WHO/ISUP classification of urothelial tumors Patients were also categorized according to the age and sex to find out the prevalence of urothelial lesions on them.Results: Out of the 78 patients 54 were males and 24 were females. Very few (n=15, 19.23%) cases of non neoplastic lesions were biopsied. Low grade urothelial carcinoma was the most common diagnosis in the patients which accounts for 49.2 % (n=31) of the total neoplastic conditions.Conclusion: Low grade urothelial carcinoma was the most common lesion encountered with the peak age range of 61-70 years.Journal of Nobel Medical College Volume 7, Number 1, Issue 12, January-June 2018, Page: 6-10

Computed Tomography Urography: Comparison of Image Quality and Radiation Dose between Single- and Split-Bolus Techniques

In this study, we aimed to compare the split-bolus and single-bolus computerised tomography (CT) urography and determine if this offers a reduction in radiation dose without compromising image quality. A retrospective evaluation was performed on 88 patients undergoing split-bolus CT urography and this was compared to a control group of 101 consecutive patients undergoing single-bolus CT urography. A radiation dose analysis was performed on each subject. Subjects with urinary bladder lesions, hydronephrosis, renal masses or cysts >3 cm in diameter were excluded. All images were classified according to image quality by 2 consultant radiologists. Opacification of the renal parenchyma, pelvicalyceal system, proximal ureters and urinary bladder were comparable between the 2 techniques, whilst image quality of the middle and distal third of the ureters was better using the split-bolus technique. The mean dose length product (DLP) for the single-bolus technique was 1324.1 mGy-cm, whilst that of the split-bolus technique was 885.7 mGy-cm. The mean effective dose reduction was calculated to be 31.1% between the 2 groups. The split-bolus technique gives a reduced radiation dose without compromising image quality. The associated reduction in images is beneficial for data storage and reporting efficiency. As such, our department will adopt the split-bolus technique for young, low-risk patients.

Synchronous urinary bladder metastasis of chromophobe renal cell carcinoma

Urinary bladder metastasis in patients with renal cell carcinoma is rare and until now <70 cases have been documented in literature. Majority of these reported cases were histologically clear cell...

Evaluation of cellular transformation and tumor aggressiveness factor expression in urinary bladder lesions and transitional cell carcinoma special variants in relation to bilharziasis

Evaluation of cellular transformation and tumor aggressiveness factor expression in urinary bladder lesions and transitional cell carcinoma special variants in relation to bilharziasis

Expression of FGFR3 Protein and Gene Amplification in Urinary Bladder Lesions in Relation to Schistosomiasis.

BACKGROUND:Bladder cancer represents the fifth most common malignancy worldwide and a major cause of cancer-related morbidity and death. Incidence and mortality rates have remained relatively constant over the past four decades. Urothelial bladder cancers have identified multiple risk factors.AIM:We aimed at evaluating the expression of the FGFR3 protein and gene amplification in the urothelial cells of neoplastic and non-neoplastic urothelial lesions of the urinary bladder, and correlation with tumour grade, stage and associated bilharziasis.MATERIAL AND METHODS:One hundred and five different urinary bladder lesions were studied, including 15 cystitis cases (9 bilharzial and 6 non-bilharzial cystitides), 75 urothelial carcinoma cases (18 bilharzial associated and 57 non-bilharzial associated) and 15 squamous cell carcinoma associated with bilharziasis, beside 5 control cases. Data concerning age, sex, tumour grade, stage, and associated bilharziasis were obtained. Each case was studied for FGFR3 expression, and FISH technique was applied on forty malignant cases that show high protein expression.RESULTS:The highest incidence of cystitis was in the fourth decade while of bladder cancer was in the seventh decade. Tumour grade was correlated significantly with tumour stage. FGFR3 correlates significantly with tumour grade, stage and with a bilharzial infestation. FGFR3 gene amplification was reported mainly in low grade and NNMBIC tumours.CONCLUSIONS:FGFR3 overexpression in malignant cases was significantly higher than in chronic cystitis. FGFR3 gene amplification was reported mainly in low grade and NNMBIC tumours. FGFR3 may be further studied as a subject for target therapy of bladder cancer.

Spectrum of histomorphological diagnosis in cystoscopic bladder biopsies

Background: Urinary bladder lesions are the main source of significant clinical symptoms which are more disabling than lethal. Bladder tumors constitute one of the most common urological pathology. Urothelial carcinoma accounts for 90% of all primary tumors of the bladder. This study aimed to determine the frequency of different types of lesions of the urinary bladder and to determine the grade and stage of urothelial tumors.Materials and Methods: This is a 2 years cross sectional study of cystoscopic biopsies carried out in the Department of Pathology, Medicare National Hospital and Research Centre, Kathmandu, Nepal.Results: Out of 87 cases, 58 (66.67%) cases were neoplastic lesions and 29(33.33%) cases were non- neoplastic lesions. Majority of neoplastic lesions 96.55% were urothelial (transitional cell) tumors comprising predominantly of low grade papillary urothelial carcinoma 50.91%. Muscle invasion was seen only in high grade papillary urothelial carcinomas.Conclusion: Among bladder tumors low grade papillary urothelial carcinoma is the most common.

Multifocal primary tumour with lesions in prostate gland and urinary bladder: clinical case

In some cases a combination of several malignant tumours in one person can be observed. In such case it is the multifocal primary tumour (MPT). The tumours combination in genitourinary system is rare phenomenon, including a rare combination of prostate and urinary bladder cancers. These pathologies can be caused by both the endogenous factors - age, gender, heredity, inflammatory and proliferative processes, abnormal inclusions (calculi and amyloids) and exogenous factors, among which the leading cause is the environmental pollution (heavy metals salts and others), bad habits, occupational hazards, oncogenic viruses and ionizing radiation. A 76 - year- old male patient, Ukrainian, was hospitalized at urology department with complaints on pollakiuria, frequent urinary retention, haematuria appeared about 1 month before. After examination of patient the preliminary diagnosis was made: «Urinary bladder cancer, acute urinary retention, macrohematuria and posthemorrhagic anemia». Based on the histological and immunohistochemical examinations, the final diagnosis was determined: combined malignant tumours - acinar adenocarcinoma of prostate index 9 (5 + 4) accordimg to D.F. Gleason and invasive urothelial carcinoma of the urinary bladder. This clinical case demonstrates that the probability of combined oncologic cancer pathology with lesions in one system is rather high. Therefore, in order to exclude the cancer combinations, the patients with malignant tumour in the genitourinary system should undergo a complex examination.Bangladesh Journal of Medical Science Vol.16(1) 2017 p.161-165

Hemangioma of the urinary bladder: an atypical location.

A two-year-old male patient was referred to the pediatric emergency room with persistent gross hematuria. Abdominal ultrasound (data not shown) revealed an echogenic formation within the urinary bladder, the formation remaining fixed during changes in decubitus. Contrast-enhanced computed tomogra-phy of the abdomen showed a partially delimited, solid-to-cystic expansile urinary bladder lesion with a vegetative component, presenting lobulated contours, a small focal calcification, and although cyamella-associated pain has been described

Clinicopathological Study of Urinary Bladder Lesions: A Retrospective Study

Clinicopathological Study of Urinary Bladder Lesions: A Retrospective Study

Structural-Functional Peculiarities of the Urinary Bladder in Postnatal Ontogenesis

It is known about the high incidence of the urinary bladder lesions in the structure of urological pathology regardless of age; however, according to the analysis of world literature sources, data on postnatal ontogenetic transformations of its wall constituents are poorly studied. Therefore, the purpose of our work was to study the morphofunctional peculiarities of the urinary bladder during sexual formation and puberty in parallel with research of pro- and antioxidant systems, as these processes are interrelated and interdependent.In compliance with bioethical principles, in the experiment on 20 immature and 20 mature white outbred male rats using a complex research methods (injection, histological, immune-histochemical, electronic-microscopic and biochemical) the structural changes in the wall of the urinary bladder and pro- and antioxidant systems in stages of postnatal ontogenesis were studied.Vascular transformations in investigated age periods occur in parallel with the transformations of cellular and non-cellular elements of the urinary bladder wall, ensuring adequacy of tissue homeostasis in ontogenesis. All this is associated with the processes of peroxidation and antioxidant systems operation, indicating their interrelationship and interdependence and strict control of the whole hierarchical system of regulation.Taking into account the peculiarities of the structural elements of the urinary bladder wall at these stages of postnatal ontogenesis, clarification of the dynamics in other age groups and under the influence of various factors is promising.