Histological Spectrums in Transurethral Resection of Bladder Tissue

Abstract

Background: Urinary bladder carcinoma is more common in elderly males than females. Urothelial (Transitional cell) carcinoma is the most common histological subtype. Objective: The purpose of present study was to describe the different histological features observed in transurethral resection of bladder tissue and to determine the association of tumor grade with stage and also of the age with grade and stage of tumor. Methods: An analytical Cross sectional study, conducted in the Department of Pathology Fatima Jinnah Medical University Lahore, Pakistan from August 2019 – April 2021. Total 80 specimens of transurethral resection of bladder tissue (TURBT) were included. All the specimens were fixed in 10% formalin and stained with Hemotoxylin Eosin stain and studied under the light microscope. urinary bladder malignancies were classified, staged and graded according to the WHO/ISUP guidelines. Results: Total n=80 cases were included in the study. Mean age of the male patients was 59± 1.13 years and 50±1.1 years in females. N=76(95%) were malignant and only 4 (5%) were benign cases. Out of 76(95%) malignant cases, 48 (63.1%) were high grade urothelial carcinoma and 28 (36.8%) were low grade carcinoma. N=33 (43.4%) were invading the lamina propria (T1) and 43 (56.5%) were invading the detrusor muscle (T2).Low grade tumors showed lamina propria invasion (T1) in 18 (64.2%) cases and muscular invasion (T2) was seen in only 10(35.7%) cases. N=33(68.7%) of high grade tumor were invading the deep muscle (T2) and 15 (31.2%) were limited to lamina propria (T1). Tumor with high grade morphology were diagnosed at advanced stage and was observed more frequent in elderly patients. Statistically significant association of tumor histological grade with stage and also of patient's age with tumor grade and stage was observed p<0.05). Conclusion: The study concluded that urinary bladder carcinoma is more common in males than females. Urothelial carcinoma is the most common type of bladder neoplasm. Patients presented with urothelial carcinoma in older age group and with high grade morphology were diagnosed at advanced stage (invading the detrusor muscle). Statistically there is significant association of tumor histological grade with stage and also of patient's age with the tumor grade and stage.