Study on Staging and Grading of Urinary Bladder Tumour with Histopathological Correlation

A cross sectional observational study was done to see the staging and grading of urinary bladder tumor along with their histopathological correlation at the Department of Pathology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The study was done during the period of July 2006 to June 2007 and total 150 cases were included those were clinically suggestive and cystoscopically or sonographically suspected cases of bladder tumor. Size of bladder, length of ureters, other organs present; tumor characteristics: size (including thickness), location extent of invasion, shape (papillary, ulcerated), multifocal lesion and appearance of non-neoplastic mucosa, thickness of bladder wall away from tumor were observed. Total 145 samples were collected by TURBT and 5 were by cystectomy. Mean age of the study patients was 58.5 years and 95.33% of them were male. Histopathologically 95.33% were papillary urothelial carcinoma, 2.66% were adenocarcinoma, 1.33% was squamous cell carcinoma and 0.66% were carcinosarcoma. Among 150 cases 72 (50.34%) bladder tumour were of high grade and 71 (49.65%) were low grade. In 7 (4.66%) cases grading were not done because they were other than papillary urothelial carcinoma. Staging were done in 93 cases and in remaining 57 cases staging was not possible due to absence of muscularis propria. 32 (21.33%) cases were stage T2, 31 (20.66%) cases T1 and 4 (2.66%) were in stage Ta. Overall findings of the cross sectional Bangladeshi population was almost similar to other developing and developed countries.

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HISTOPATHOLOGICAL SPECTRUM OF UROTHELIAL LESIONS: AN OBSERVATIONAL STUDY

10.36106/paripex/5201627 ◽

2020 ◽

pp. 1-4

Author(s):

Nishat Ahmad ◽

Saurabh Banerjee ◽

A K. Srivastava

Keyword(s):

Urinary Bladder ◽

Urothelial Carcinoma ◽

Bladder Tumour ◽

Histopathological Analysis ◽

Low Grade ◽

High Grade ◽

Urothelial Carcinomas ◽

Neoplastic Lesions ◽

Papillary Urothelial Carcinoma ◽

Muscle Invasion

BACKGROUND: Urinary bladder cancer is second most common cancer after prostate cancer in the genitourinary system. Urothelial Carcinoma is the commonest tumour type accounting for 90% of all primary tumours of the bladder Histopathological analysis of cystoscopic bladder biopsy and Transurethral resection of the bladder tumour (TURBT) material are the mainstay for cancer diagnosis. This study was aimed to determine the frequency of different types of neoplastic lesions of the urinary bladder and to determine the grade and stage of urothelial tumours. MATERIAL METHOD: The study was carried out in the Department of Pathology, Rajendra Institute of Medical Sciences (RIMS), Ranchi from January 2018 to June 2020 and included 30 cases of cystoscopic biopsies and TURBT specimens. RESULTS: Out of 30 cases of neoplastic lesions, majority were of high grade papillary urothelial carcinoma (n=14, 46.67%) followed by low grade papillary urothelial carcinoma (n=9, 30%), 3 cases (10%) were of PUNLMP, 2 cases (6.66%) of papilloma and 1 (3.33%) case each of moderately differentiated squamous cell carcinoma and extra nodal NHL. The most common age group was 41-50 years and 51-60 years with 9 (30%) cases each. Muscle invasion was seen only in high grade papillary urothelial carcinomas. CONCLUSION: High-grade urothelial carcinomas with lamina propria and muscle invasion are the most common neoplastic lesion of urinary bladder with significant morbidity and mortality. Muscle invasion and grading, as per TNM staging, are valuable prognostic factors.

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Spectrum of histomorphological diagnosis in cystoscopic bladder biopsies

Journal of Pathology of Nepal ◽

10.3126/jpn.v7i1.16913 ◽

2017 ◽

Vol 7 (1) ◽

pp. 1062-1065

Author(s):

R Thapa ◽

M Lakhey ◽

AD Bhatta

Keyword(s):

Urinary Bladder ◽

Urothelial Carcinoma ◽

Clinical Symptoms ◽

Transitional Cell ◽

Research Centre ◽

Low Grade ◽

Bladder Tumors ◽

Primary Tumors ◽

Neoplastic Lesions ◽

Papillary Urothelial Carcinoma

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.

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HER2 / neu Overexpression in Urothelial Carcinoma and Its Association with Tumour Grading - A Cross Sectional Study from a Tertiary Care Hospital in Kerala

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/97 ◽

2021 ◽

Vol 8 (9) ◽

pp. 497-501

Author(s):

Sebina Asmi A.T ◽

Suma Madathiveetil

Keyword(s):

Urothelial Carcinoma ◽

Growth Factor Receptor ◽

Cross Sectional Study ◽

Low Grade ◽

High Grade ◽

Sectional Study ◽

Tumour Grade ◽

Cross Sectional ◽

Epidermal Growth ◽

Papillary Urothelial Carcinoma

BACKGROUND Human epidermal growth factor receptor-2 HER2 / neu, is a trans membrane tyrosine kinase receptor of epidermal growth factor receptor (EGFR) family and is involved in the pathogenesis of urinary bladder cancer. In this study we attempted to evaluate the HER2 / neu expression in urothelial carcinoma of bladder and its association with tumour grading. METHODS This was a cross sectional study with a sample size of 75. Routine 4 micrometre thick sections of formalin fixed paraffin embedded tissue blocks stained with haematoxylin & eosin were reviewed. Tumour grade was determined by using the World Health Organization (WHO) / International Society of Urological Pathologist criteria (ISUP). Immunohistochemistry was done by using HER2 / neu monoclonal antibody and its expression were observed. The membrane staining intensity and pattern were studied and scored. RESULTS In our study 75 cases of urothelial carcinoma were studied, of which 49 cases were papillary urothelial carcinoma low grade, 26 cases were papillary urothelial carcinoma high grade. Among these, 19 cases were infiltrating urothelial carcinoma. HER2 / neu positivity were observed in 27 (36 %) cases and overexpression in 8 (10 %) cases. Low grade urothelial carcinoma showed HER2 / neu positivity in 11 (22 %) cases and overexpression in 1 (2 %) case. High grade urothelial carcinoma showed HER2 / neu positivity in 16 (64 %) cases, among which 7 (28 %) cases showed overexpression. HER2 / neu positivity was seen in 13 (68 %) cases of infiltrating urothelial carcinoma with 4 (21 %) cases showing overexpression. A statistically significant difference in HER2 / neu expression was noted in high grade and invasive urothelial carcinoma compared to low grade and non-invasive urothelial carcinoma. CONCLUSIONS Urothelial carcinomas show overexpression of HER2 / neu and this over expression increases with increasing grade of tumour and muscle invasiveness. KEYWORDS Urothelial Carcinoma, HER2 / neu, Overexpression, Tumour Grade, Trastuzumab

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Incidence of various urothelial malignancy in patients undergoing transurethral resection of bladder tumour in tertiary care hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20205823 ◽

2020 ◽

Vol 8 (1) ◽

pp. 346

Author(s):

Kamal Preet Kaur ◽

Gurpreet Singh Bhangu ◽

Darpan Bansal ◽

Divya Julka

Keyword(s):

Urinary Bladder ◽

Urothelial Carcinoma ◽

Transurethral Resection ◽

Bladder Tumor ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

High Grade ◽

Urothelial Malignancy ◽

Papillary Urothelial Carcinoma

Background: Urinary bladder lesions are a great health concern as it lies among the top ten most common cancers in the world. These range from benign, harmless lesions that do not recur to life threatening tumors. The present study was undertaken to study incidence of various urothelial cancer in patients undergoing transurethral resection of bladder tumor in tertiary care hospital, as the treatment, follow up and prognosis is highly variable with different subtypes of bladder cancer.Methods: A hospital based descriptive cross-sectional study was conducted on all patients undergoing transurethral resection of bladder tumor from December 2018 to May 2020 in the Department of General Surgery of Sri Guru Ramdas Institute of Medical Sciences and Research, Amritsar. Based on World Health Organization (WHO) classification incidence of various urothelial malignancy was calculated.Results: Out of 80 patients with growth urinary bladder, 4 patients (5% of total patient) were diagnosed as case of papilloma, 26 patients (32.5% of total patients) were diagnosed as low grade papillary urothelial carcinoma, 50 patients (62.5% of total patients) were of high grade papillary urothelial carcinoma. There were no case of PUNLMP in our study.Conclusions: It can be concluded that majority of the patient undergoing transurethral resection of bladder tumor are diagnosed with high grade papillary carcinoma.

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Comparison between 1973 and 2004/2016 WHO grading systems in patients with Ta urothelial carcinoma of urinary bladder

Journal of Clinical Pathology ◽

10.1136/jclinpath-2021-207400 ◽

2021 ◽

pp. jclinpath-2021-207400

Author(s):

Claudia Collà Ruvolo ◽

Christoph Würnschimmel ◽

Mike Wenzel ◽

Luigi Nocera ◽

Gianluigi Califano ◽

...

Keyword(s):

Urinary Bladder ◽

Urothelial Carcinoma ◽

Cox Regression ◽

Bladder Tumour ◽

Grading System ◽

Low Grade ◽

High Grade ◽

Who Grade ◽

Kaplan Meier ◽

Grading Systems

AimsTo compare the 1973 WHO and the 2004/2016 WHO grading systems in patients with urothelial carcinoma of urinary bladder (UCUB), since no consensus has been made which classification should supersede the other and since both are recommended in clinical practice.MethodsNewly diagnosed patients with Ta UCUB treated with transurethral resection of bladder tumour were abstracted from the Surveillance, Epidemiology and End Results database (2010–2016). Kaplan-Meier plots and multivariable Cox regression models (CRMs) tested cancer-specific mortality (CSM), according to 1973 WHO (G1 vs G2 vs G3) and to 2004/2016 WHO (low-grade vs high-grade) grading systems.ResultsOf 35 986 patients, according to 1973 WHO grading system, 8165 (22.7%) were G1, 17 136 (47.6%) were G2 and 10 685 (29.7%) were G3. According to 2004/2016 WHO grading system, 24 961 (69.4%) were low-grade versus 11 025 (30.6%) high-grade. In multivariable CRMs, G3 (HR: 2.05, p<0.001), relative to G1, and high-grade(HR: 2.13, p<0.001), relative to low-grade, predicted higher CSM. Conversely, G2 (p=0.8) was not an independent predictor. The multivariable models without consideration of either grading system were 74% accurate in predicting 5-year CSM. After addition of 1973 WHO or 2004/2016 WHO grade, the accuracy increased to 76% and 77%, respectively.ConclusionsFrom a statistical standpoint, it appears that the 2004/2016 WHO grading system holds a small, although measurable advantage over the 1973 WHO grading system. Other considerations, such as intraobserver and interobserver variability may represent an additional matric to consider in deciding which grading system is better.

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A histopathologic study of urinary bladder tumors at tertiary care center in Mid-Western region of Nepal

Asian Journal of Medical Sciences ◽

10.3126/ajms.v9i6.20685 ◽

2018 ◽

Vol 9 (6) ◽

pp. 45-50

Author(s):

Binita Goyal ◽

Sheshagiri Rao ◽

Rajina Sahi ◽

Subechhya Jaiswal

Keyword(s):

Urinary Bladder ◽

Urothelial Carcinoma ◽

Low Grade ◽

High Grade ◽

Medical Sciences ◽

Bladder Tumors ◽

Common Cancer ◽

Urothelial Tumors ◽

Papillary Urothelial Carcinoma ◽

Muscle Invasion

Background: Urinary bladder cancer is an important cause of morbidity and mortality due to urological conditions. It is tenth most common cancer overall in both sexes. It is seventh most common cancer overall and second most common cancer of genitourinary tract in males. Ninety five percent of bladder tumors are epithelial and the rest are mesenchymal, of which majority are primary urothelial tumors. Urothelial tumors are classified into infiltrating urothelial carcinoma with its variants and non-invasive urothelial neoplasias. Tumor stage is the strongest prognostic parameter.Aims and Objectives: The current study was designed with an aim to elucidate the histologic pattern of bladder tumors and observe whether any association between histologic grade and muscle invasion exists.Materials and Methods: This descriptive study was carried out on 84 cases of urinary bladder tumors received in Department of Pathology, College of Medical Sciences and Teaching Hospital during a time period of 5 years from January 2012 to December 2016.Results: The mean ± SD of age of presentation was 63±13 years with a male female ratio 3.2:1. Ninety-five percent cases were primary epithelial tumors and 93% cases were of urothelial origin. Low grade papillary urothelial carcinoma was the most common urothelial tumor (40.5%) followed by high grade papillary urothelial carcinoma (34.5%). Some rare types like primary adenocarcinoma and small cell carcinoma were also seen in this study (1.2% each). Muscle invasion was significantly higher in high grade (66%) as compared to low grade papillary urothelial carcinoma (3%). Muscle tissue was absent in 8 (9.5%) cases.Conclusion: There is relationship of histologic grade with aggressiveness of tumor. Most of the high grade tumors are muscle invasive at presentation. Submission of muscle tissue is important for optimal patient management.Asian Journal of Medical Sciences Vol.9(6) 2018 45-50

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